The Pathway to a Safe and Effective Medication Formulary for Exploration Spaceflight

Science.gov (United States)

Daniels, V. R.; Bayuse, T. M.; Mulcahy, R. A.; Mcguire, R. K. M.; Antonsen, E. L.

2017-01-01

PURPOSE: Exploration space missions pose several challenges to providing a comprehensive medication formulary designed to accommodate the size and space limitations of the spacecraft; while addressing the individual medications needs and preferences of the Crew; the negative outcome of a degrading inventory over time, the inability to resupply before expiration dates; and the need to properly forecast the best possible medication candidates to treat conditions that will occur in the future. METHODS: The Pharmacotherapeutics Discipline has partnered with the Exploration Medical Capabilities (ExMC) Element to develop and propose a research pathway that is comprehensively focused on evidence-based models and theories, as well as on new diagnostic tools and treatments or preventive measures aimed at closure of the Med02 “Pharmacy” Gap; defined in the Human Research Program’s (HRP) risk-based research strategy. The Med02 Gap promotes the challenge to identify a strategy to ensure that medications used to treat medical conditions during exploration space missions are available, safe, and effective. It is abundantly clear that pharmaceutical intervention is an essential component of risk management planning for astronaut healthcare during exploration space. However, the quandary still remains of how to assemble a formulary that is comprehensive enough to prevent or treat anticipated medical events; and is also chemically stable, safe, and robust enough to have sufficient potency to last for the duration of an exploration space mission. In cases where that is not possible, addressing this Gap requires exploration of novel drug development techniques, dosage forms, and dosage delivery platforms that enhance chemical stability as well as therapeutic effectiveness. RESULTS: The proposed research pathway outlines the steps, processes, procedures, and a research portfolio aimed at identifying a capability that will provide a safe and effective pharmacy for any specific

Clinical capabilities of graduates of an outcomes-based integrated medical program

Directory of Open Access Journals (Sweden)

Scicluna Helen A

2012-06-01

Full Text Available Abstract Background The University of New South Wales (UNSW Faculty of Medicine replaced its old content-based curriculum with an innovative new 6-year undergraduate entry outcomes-based integrated program in 2004. This paper is an initial evaluation of the perceived and assessed clinical capabilities of recent graduates of the new outcomes-based integrated medical program compared to benchmarks from traditional content-based or process-based programs. Method Self-perceived capability in a range of clinical tasks and assessment of medical education as preparation for hospital practice were evaluated in recent graduates after 3 months working as junior doctors. Responses of the 2009 graduates of the UNSW’s new outcomes-based integrated medical education program were compared to those of the 2007 graduates of UNSW’s previous content-based program, to published data from other Australian medical schools, and to hospital-based supervisor evaluations of their clinical competence. Results Three months into internship, graduates from UNSW’s new outcomes-based integrated program rated themselves to have good clinical and procedural skills, with ratings that indicated significantly greater capability than graduates of the previous UNSW content-based program. New program graduates rated themselves significantly more prepared for hospital practice in the confidence (reflective practice, prevention (social aspects of health, interpersonal skills (communication, and collaboration (teamwork subscales than old program students, and significantly better or equivalent to published benchmarks of graduates from other Australian medical schools. Clinical supervisors rated new program graduates highly capable for teamwork, reflective practice and communication. Conclusions Medical students from an outcomes-based integrated program graduate with excellent self-rated and supervisor-evaluated capabilities in a range of clinically-relevant outcomes. The program

Implementing NASA's Capability-Driven Approach: Insight into NASA's Processes for Maturing Exploration Systems

Science.gov (United States)

Williams-Byrd, Julie; Arney, Dale; Rodgers, Erica; Antol, Jeff; Simon, Matthew; Hay, Jason; Larman, Kevin

2015-01-01

NASA is engaged in transforming human spaceflight. The Agency is shifting from an exploration-based program with human activities focused on low Earth orbit (LEO) and targeted robotic missions in deep space to a more sustainable and integrated pioneering approach. Through pioneering, NASA seeks to address national goals to develop the capacity for people to work, learn, operate, live, and thrive safely beyond the Earth for extended periods of time. However, pioneering space involves more than the daunting technical challenges of transportation, maintaining health, and enabling crew productivity for long durations in remote, hostile, and alien environments. This shift also requires a change in operating processes for NASA. The Agency can no longer afford to engineer systems for specific missions and destinations and instead must focus on common capabilities that enable a range of destinations and missions. NASA has codified a capability driven approach, which provides flexible guidance for the development and maturation of common capabilities necessary for human pioneers beyond LEO. This approach has been included in NASA policy and is captured in the Agency's strategic goals. It is currently being implemented across NASA's centers and programs. Throughout 2014, NASA engaged in an Agency-wide process to define and refine exploration-related capabilities and associated gaps, focusing only on those that are critical for human exploration beyond LEO. NASA identified 12 common capabilities ranging from Environmental Control and Life Support Systems to Robotics, and established Agency-wide teams or working groups comprised of subject matter experts that are responsible for the maturation of these exploration capabilities. These teams, called the System Maturation Teams (SMTs) help formulate, guide and resolve performance gaps associated with the identified exploration capabilities. The SMTs are defining performance parameters and goals for each of the 12 capabilities

Medical capability team: the clinical microsystem for combat healthcare delivery in counterinsurgency operations.

Science.gov (United States)

Clark, Susz; Van Steenvort, Jon K

2008-01-01

Today's operational environment in the support of counterinsurgency operations requires greater tactical and operational flexibility and diverse medical capabilities. The skills and organizations required for full spectrum medical operations are different from those of the past. Combat healthcare demands agility and the capacity for rapid change in clinical systems and processes to better support the counterinsurgency environment. This article proposes the Army Medical Department (AMEDD) develop and implement the medical capability team (MCT) for combat healthcare delivery. It discusses using the concept of the brigade combat team to develop medical capability teams as the unit of effectiveness to transform frontline care; provides a theoretical overview of the MCT as a "clinical microsystem"; discusses MCT leadership, training, and organizational support, and the deployment and employment of the MCT in a counterinsurgency environment. Additionally, this article proposes that the AMEDD initiate the development of an AMEDD Combat Training Center of Excellence to train and validate the MCTs. The complexity of combat healthcare demands an agile and campaign quality AMEDD with joint expeditionary capability in order to promote the best patient outcomes in a counterinsurgency environment.

Exploration Medical System Demonstration Project

Science.gov (United States)

Chin, D. A.; McGrath, T. L.; Reyna, B.; Watkins, S. D.

2011-01-01

A near-Earth Asteroid (NEA) mission will present significant new challenges including hazards to crew health created by exploring a beyond low earth orbit destination, traversing the terrain of asteroid surfaces, and the effects of variable gravity environments. Limited communications with ground-based personnel for diagnosis and consultation of medical events require increased crew autonomy when diagnosing conditions, creating treatment plans, and executing procedures. Scope: The Exploration Medical System Demonstration (EMSD) project will be a test bed on the International Space Station (ISS) to show an end-to-end medical system assisting the Crew Medical Officers (CMO) in optimizing medical care delivery and medical data management during a mission. NEA medical care challenges include resource and resupply constraints limiting the extent to which medical conditions can be treated, inability to evacuate to Earth during many mission phases, and rendering of medical care by a non-clinician. The system demonstrates the integration of medical technologies and medical informatics tools for managing evidence and decision making. Project Objectives: The objectives of the EMSD project are to: a) Reduce and possibly eliminate the time required for a crewmember and ground personnel to manage medical data from one application to another. b) Demonstrate crewmember's ability to access medical data/information via a software solution to assist/aid in the treatment of a medical condition. c) Develop a common data management architecture that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all crew health and life sciences activities. d) Develop a common data management architecture that allows for scalability, extensibility, and interoperability of data sources and data users. e) Lower total cost of ownership for development and sustainment of peripheral hardware and software that use EMSD for data management f) Provide

NASA's Space Launch System: A New Capability for Science and Exploration

Science.gov (United States)

Crumbly, Christopher M.; May, Todd A.; Robinson, Kimberly F.

2014-01-01

The National Aeronautics and Space Administration's (NASA's) Marshall Space Flight Center (MSFC) is directing efforts to build the Space Launch System (SLS), a heavy-lift rocket that will launch the Orion Multi-Purpose Crew Vehicle (MPCV) and other high-priority payloads into deep space. Its evolvable architecture will allow NASA to begin with human missions beyond the Moon and then go on to transport astronauts or robots to distant places such as asteroids and Mars. Developed with the goals of safety, affordability, and sustainability in mind, SLS will start with 10 percent more thrust than the Saturn V rocket that launched astronauts to the Moon 40 years ago. From there it will evolve into the most powerful launch vehicle ever flown, via an upgrade approach that will provide building blocks for future space exploration. This paper will explain how NASA will execute this development within flat budgetary guidelines by using existing engines assets and heritage technology, from the initial 70 metric ton (t) lift capability through a block upgrade approach to an evolved 130-t capability, and will detail the progress that has already been made toward a first launch in 2017. This paper will also explore the requirements needed for human missions to deep-space destinations and for game-changing robotic science missions, and the capability of SLS to meet those requirements and enable those missions, along with the evolution strategy that will increase that capability. The International Space Exploration Coordination Group, representing 12 of the world's space agencies, has worked together to create the Global Exploration Roadmap, which outlines paths towards a human landing on Mars, beginning with capability-demonstrating missions to the Moon or an asteroid. The Roadmap and corresponding NASA research outline the requirements for reference missions for all three destinations. The SLS will offer a robust way to transport international crews and the air, water, food, and

Exploration Laboratory Analysis

Science.gov (United States)

Krihak, M.; Ronzano, K.; Shaw, T.

2016-01-01

The Exploration Laboratory Analysis (ELA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the availability of inflight laboratory analysis instrumentation has been identified as an essential capability for manned exploration missions. Since a single, compact space-ready laboratory analysis capability to perform all exploration clinical measurements is not commercially available, the ELA project objective is to demonstrate the feasibility of emerging operational and analytical capability as a biomedical diagnostics precursor to long duration manned exploration missions. The initial step towards ground and flight demonstrations in fiscal year (FY) 2015 was the down selection of platform technologies for demonstrations in the space environment. The technologies selected included two Small Business Innovation Research (SBIR) performers: DNA Medicine Institutes rHEALTH X and Intelligent Optical Systems later flow assays combined with Holomics smartphone analyzer. The selection of these technologies were based on their compact size, breadth of analytical capability and favorable ability to process fluids in a space environment, among several factors. These two technologies will be advanced to meet ground and flight demonstration success criteria and requirements that will be finalized in FY16. Also, the down selected performers will continue the technology development phase towards meeting prototype deliverables in either late 2016 or 2017.

Medical Data Architecture Project Status

Science.gov (United States)

Krihak, M.; Middour, C.; Gurram, M.; Wolfe, S.; Marker, N.; Winther, S.; Ronzano, K.; Bolles, D.; Toscano, W.; Shaw, T.

2018-01-01

The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm. The medical system requirements are being developed in parallel with the exploration mission architecture and vehicle design. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products supported by current prototype development will directly inform exploration medical system requirements.

Exploring synchrotron radiation capabilities: The ALS-Intel CRADA

International Nuclear Information System (INIS)

Gozzo, F.; Cossy-Favre, A.; Padmore, H.

1997-01-01

Synchrotron radiation spectroscopy and spectromicroscopy were applied, at the Advanced Light Source, to the analysis of materials and problems of interest to the commercial semiconductor industry. The authors discuss some of the results obtained at the ALS using existing capabilities, in particular the small spot ultra-ESCA instrument on beamline 7.0 and the AMS (Applied Material Science) endstation on beamline 9.3.2. The continuing trend towards smaller feature size and increased performance for semiconductor components has driven the semiconductor industry to invest in the development of sophisticated and complex instrumentation for the characterization of microstructures. Among the crucial milestones established by the Semiconductor Industry Association are the needs for high quality, defect free and extremely clean silicon wafers, very thin gate oxides, lithographies near 0.1 micron and advanced material interconnect structures. The requirements of future generations cannot be met with current industrial technologies. The purpose of the ALS-Intel CRADA (Cooperative Research And Development Agreement) is to explore, compare and improve the utility of synchrotron-based techniques for practical analysis of substrates of interest to semiconductor chip manufacturing. The first phase of the CRADA project consisted in exploring existing ALS capabilities and techniques on some problems of interest. Some of the preliminary results obtained on Intel samples are discussed here

Medical Data Architecture (MDA) Project Status

Science.gov (United States)

Krihak, M.; Middour, C.; Gurram, M.; Wolfe, S.; Marker, N.; Winther, S.; Ronzano, K.; Bolles, D.; Toscano, W.; Shaw, T.

2018-01-01

The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm. The medical system requirements are being developed in parallel with the exploration mission architecture and vehicle design. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products supported by current prototype development will directly inform exploration medical system requirements.

Decision Analysis Methods Used to Make Appropriate Investments in Human Exploration Capabilities and Technologies

Science.gov (United States)

Williams-Byrd, Julie; Arney, Dale C.; Hay, Jason; Reeves, John D.; Craig, Douglas

2016-01-01

NASA is transforming human spaceflight. The Agency is shifting from an exploration-based program with human activities in low Earth orbit (LEO) and targeted robotic missions in deep space to a more sustainable and integrated pioneering approach. Through pioneering, NASA seeks to address national goals to develop the capacity for people to work, learn, operate, live, and thrive safely beyond Earth for extended periods of time. However, pioneering space involves daunting technical challenges of transportation, maintaining health, and enabling crew productivity for long durations in remote, hostile, and alien environments. Prudent investments in capability and technology developments, based on mission need, are critical for enabling a campaign of human exploration missions. There are a wide variety of capabilities and technologies that could enable these missions, so it is a major challenge for NASA's Human Exploration and Operations Mission Directorate (HEOMD) to make knowledgeable portfolio decisions. It is critical for this pioneering initiative that these investment decisions are informed with a prioritization process that is robust and defensible. It is NASA's role to invest in targeted technologies and capabilities that would enable exploration missions even though specific requirements have not been identified. To inform these investments decisions, NASA's HEOMD has supported a variety of analysis activities that prioritize capabilities and technologies. These activities are often based on input from subject matter experts within the NASA community who understand the technical challenges of enabling human exploration missions. This paper will review a variety of processes and methods that NASA has used to prioritize and rank capabilities and technologies applicable to human space exploration. The paper will show the similarities in the various processes and showcase instances were customer specified priorities force modifications to the process. Specifically

NASA Laboratory Analysis for Manned Exploration Missions

Science.gov (United States)

Krihak, Michael K.; Shaw, Tianna E.

2014-01-01

The Exploration Laboratory Analysis (ELA) project supports the Exploration Medical Capability Element under the NASA Human Research Program. ELA instrumentation is identified as an essential capability for future exploration missions to diagnose and treat evidence-based medical conditions. However, mission architecture limits the medical equipment, consumables, and procedures that will be available to treat medical conditions during human exploration missions. Allocated resources such as mass, power, volume, and crew time must be used efficiently to optimize the delivery of in-flight medical care. Although commercial instruments can provide the blood and urine based measurements required for exploration missions, these commercial-off-the-shelf devices are prohibitive for deployment in the space environment. The objective of the ELA project is to close the technology gap of current minimally invasive laboratory capabilities and analytical measurements in a manner that the mission architecture constraints impose on exploration missions. Besides micro gravity and radiation tolerances, other principal issues that generally fail to meet NASA requirements include excessive mass, volume, power and consumables, and nominal reagent shelf-life. Though manned exploration missions will not occur for nearly a decade, NASA has already taken strides towards meeting the development of ELA medical diagnostics by developing mission requirements and concepts of operations that are coupled with strategic investments and partnerships towards meeting these challenges. This paper focuses on the remote environment, its challenges, biomedical diagnostics requirements and candidate technologies that may lead to successful blood-urine chemistry and biomolecular measurements in future space exploration missions.

Career exploration behavior of Korean medical students

Directory of Open Access Journals (Sweden)

Hyejin An

2017-09-01

Full Text Available Purpose This study is to analyze the effects of medical students’ social support and career barriers on career exploration behavior mediated by career decision-making self-efficacy. Methods We applied the t-test to investigate the difference among the variables based on gender and admission types. Also, we performed path analysis to verify the effect of perceived career barriers and social support on career exploration behavior with career decision efficacy as a mediator. Results First, we noted statistically significant gender and admission type difference in social support, career barriers and career exploration behaviors. Second, social support and career barriers were found to influence career exploration behavior as a mediating variable for career decision-making self-efficacy. Conclusion Social support and career barriers as perceived by medical students influenced their career exploration behavior, with their decision-making self-efficacy serving as a full mediator. Therefore, this study has educational implications for career program development and educational training for career decision-making self-efficacy.

Career exploration behavior of Korean medical students.

Science.gov (United States)

An, Hyejin; Lee, Seung-Hee

2017-09-01

This study is to analyze the effects of medical students' social support and career barriers on career exploration behavior mediated by career decision-making self-efficacy. We applied the t-test to investigate the difference among the variables based on gender and admission types. Also, we performed path analysis to verify the effect of perceived career barriers and social support on career exploration behavior with career decision efficacy as a mediator. First, we noted statistically significant gender and admission type difference in social support, career barriers and career exploration behaviors. Second, social support and career barriers were found to influence career exploration behavior as a mediating variable for career decision-making self-efficacy. Social support and career barriers as perceived by medical students influenced their career exploration behavior, with their decision-making self-efficacy serving as a full mediator. Therefore, this study has educational implications for career program development and educational training for career decision-making self-efficacy.

Capable design or designing capabilities? An exploration of service design as an emerging organizational capability in Telenor – Martinkenaite

Directory of Open Access Journals (Sweden)

Ieva Martinkenaite

2017-01-01

Full Text Available This empirical paper examines a process, starting with the managerial decision to make service design an organizational capability, and follows it as it unfolds over time within one organization. Service design has become an established business practice of how firms create new products and services to promote differentiation in an increasingly uncertain business landscape. Implicit in the literature on service design are assumptions about strategic implications of adopting the prescribed innovation methods and tools. However, little is known about how service design evolves into an organizational capability enabling firms to transform their existing businesses and sustain competitiveness. Through a longitudinal, exploratory case study of service design practices in one of the world’s largest telecommunications companies, we explicate mechanisms through which service design evolves into an organizational capability by exploring the research question: what are the mechanisms through which service design develops into an organizational capability? Our study reveals the effect of an initial introduction of service design tools, identification of boundaryspanning actors and co-alignment of dedicated resources between internal functions, as well as through co-creation with customers. Over time, these activities lead to the adoption of service design practices, and subsequently these practices spark incremental learning throughout the organization, alter managerial decisions and influence multiple paths for the development of new capabilities. Reporting on this process, we are able to describe how service design practices were disseminated and institutionalized within the organization we observed. This study thus contributes by informing how service design can evolve into an organizational capability, as well as by bridging the emerging literature on service design and design thinking with established strategy theory. Further research will have to

Exploring Factors Affecting Emergency Medical Services Staffs' Decision about Transporting Medical Patients to Medical Facilities

OpenAIRE

Ebrahimian, Abbasali; Seyedin, Hesam; Jamshidi-Orak, Roohangiz; Masoumi, Gholamreza

2014-01-01

Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs’ decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed u...

Exploration Laboratory Analysis FY13

Science.gov (United States)

Krihak, Michael; Perusek, Gail P.; Fung, Paul P.; Shaw, Tianna, L.

2013-01-01

The Exploration Laboratory Analysis (ELA) project supports the Exploration Medical Capability (ExMC) risk, which is stated as the Risk of Inability to Adequately Treat an Ill or Injured Crew Member, and ExMC Gap 4.05: Lack of minimally invasive in-flight laboratory capabilities with limited consumables required for diagnosing identified Exploration Medical Conditions. To mitigate this risk, the availability of inflight laboratory analysis instrumentation has been identified as an essential capability in future exploration missions. Mission architecture poses constraints on equipment and procedures that will be available to treat evidence-based medical conditions according to the Space Medicine Exploration Medical Conditions List (SMEMCL), and to perform human research studies on the International Space Station (ISS) that are supported by the Human Health and Countermeasures (HHC) element. Since there are significant similarities in the research and medical operational requirements, ELA hardware development has emerged as a joint effort between ExMC and HHC. In 2012, four significant accomplishments were achieved towards the development of exploration laboratory analysis for medical diagnostics. These achievements included (i) the development of high priority analytes for research and medical operations, (ii) the development of Level 1 functional requirements and concept of operations documentation, (iii) the selection and head-to-head competition of in-flight laboratory analysis instrumentation, and (iv) the phase one completion of the Small Business Innovation Research (SBIR) projects under the topic Smart Phone Driven Blood-Based Diagnostics. To utilize resources efficiently, the associated documentation and advanced technologies were integrated into a single ELA plan that encompasses ExMC and HHC development efforts. The requirements and high priority analytes was used in the selection of the four in-flight laboratory analysis performers. Based upon the

Medical Data Architecture Project Status

Science.gov (United States)

Krihak, M.; Middour, C.; Lindsey, A.; Marker, N.; Wolfe, S.; Winther, S.; Ronzano, K.; Bolles, D.; Toscano, W.; Shaw, T.

2017-01-01

The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current International Space Station (ISS) medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable an increasingly autonomous crew than the current ISS paradigm. The MDA will develop capabilities that support automated data collection, and the necessary functionality and challenges in executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. To attain this goal, the first year of the MDA project focused on reducing technical risk, developing documentation and instituting iterative development processes that established the basis for the first version of MDA software (or Test Bed 1). Test Bed 1 is based on a nominal operations scenario authored by the ExMC Element Scientist. This narrative was decomposed into a Concept of Operations that formed the basis for Test Bed 1 requirements. These requirements were successfully vetted through the MDA Test Bed 1 System Requirements Review, which permitted the MDA project to begin software code development and component integration. This paper highlights the MDA objectives, development processes, and accomplishments, and identifies the fiscal year 2017 milestones and

Sustainability, Learning and Capability: Exploring Questions of Balance

Directory of Open Access Journals (Sweden)

William A. H. Scott

2010-12-01

Full Text Available It is argued that sustainable development makes best sense as a social learning process that brings tangible and useful outcomes in terms of understanding and skills, and also reinforces the motivation and capability for further learning. Thus, there are always balances to be struck between a broad-based, wide-ranging education and a more specialist one; between a focus on ideas themselves, and on their application in social or economic contexts; and between keeping ideas separate, and integrating them. This paper will explore the nature of such balances, and the issues to bear in mind when striking them, focusing on schools, university and college contexts within the United Kingdom.

The clinicide phenomenon: an exploration of medical murder.

Science.gov (United States)

Kaplan, Robert

2007-08-01

The aim of this paper is to explore the phenomenon of clinicide. The study of medical killers is barely in its infancy. Clinicide is the unnatural death of multiple patients in the course of treatment by a doctor. Serial medical killing is a relatively new phenomenon. The role model is Dr Marcel Petiot, the worst serial killer in French history. More recently, Dr Harold Shipman was Britain's worst serial killer and in the United States and Zimbabwe, Dr Michael Swango killed 60 patients. A number of doctors have such high patient death rates that it cannot be ignored. At some level, these doctors have an awareness of what they are doing, countered by an overweening refusal to acknowledge the implications or desist from further treatment. Treatment killer offences usually occur on the basis of serial mental illness, but may include the contentious area of euthanasia killing. Doctors have frequently been accomplices in state repression, brutality and genocide in direct contravention to their sanctioned role to relieve suffering and save life. They have become mass murderers on an exponential scale, making any comparison with a doctor killing his own patients almost risible. Many clinicidal doctors have extreme narcissistic personalities, a grandiose view of their own capability and inability to accept that they could be criticized or need assistance from other doctors. Such doctors develop a God-complex, getting a vicarious thrill out of ending suffering and by determining when a person dies.

National Aeronautics and Space Administration (NASA) Environmental Control and Life Support (ECLS) Capability Roadmap Development for Exploration

Science.gov (United States)

Bagdigian, Robert M.; Carrasquillo, Robyn L.; Metcalf, Jordan; Peterson, Laurie

2012-01-01

NASA is considering a number of future human space exploration mission concepts. Although detailed requirements and vehicle architectures remain mostly undefined, near-term technology investment decisions need to be guided by the anticipated capabilities needed to enable or enhance the mission concepts. This paper describes a roadmap that NASA has formulated to guide the development of Environmental Control and Life Support Systems (ECLSS) capabilities required to enhance the long-term operation of the International Space Station (ISS) and enable beyond-Low Earth Orbit (LEO) human exploration missions. Three generic mission types were defined to serve as a basis for developing a prioritized list of needed capabilities and technologies. Those are 1) a short duration micro gravity mission; 2) a long duration transit microgravity mission; and 3) a long duration surface exploration mission. To organize the effort, ECLSS was categorized into three major functional groups (atmosphere, water, and solid waste management) with each broken down into sub-functions. The ability of existing, flight-proven state-of-the-art (SOA) technologies to meet the functional needs of each of the three mission types was then assessed. When SOA capabilities fell short of meeting the needs, those "gaps" were prioritized in terms of whether or not the corresponding capabilities enable or enhance each of the mission types. The resulting list of enabling and enhancing capability gaps can be used to guide future ECLSS development. A strategy to fulfill those needs over time was then developed in the form of a roadmap. Through execution of this roadmap, the hardware and technologies needed to enable and enhance exploration may be developed in a manner that synergistically benefits the ISS operational capability, supports Multi-Purpose Crew Vehicle (MPCV) development, and sustains long-term technology investments for longer duration missions. This paper summarizes NASA s ECLSS capability roadmap

Exploring leadership capability and emotional intelligence as moderators of workplace bullying.

Science.gov (United States)

Hutchinson, Marie; Hurley, John

2013-04-01

This study aimed to explore the potential for emotionally intelligent leadership as a way to mitigate bullying behaviour within nursing workplace environments. As the body of evidence about bullying continues to grow there is an increasing need for researchers to direct their attention to developing theoretical frameworks that explain how bullying and victimization occur, and the types of strategies that may address the problem. The narrative synthesis of the literature presented in this paper is forwarded as supporting the need for strengthening leadership capability, especially those capabilities associated with emotional intelligence, as a means of diminishing experienced bullying within nursing. Stemming from our expanding understandings about bullying is an appreciation of the range of factors within organizations that influence the occurrence of bullying, and an awareness of the need to understand the expression, experience and management of emotions in the workplace. While both leadership and emotional intelligence capabilities offer real potential to mitigate bullying behaviour, disparity exits between clinical and managerial nurses toward preferred leadership styles and emotional intelligence is open to challenges towards its content validity. Nursing management is challenged to build upon procedural responses to bullying to include a ground up approach to leadership enhancement capability, better responses to emotions in the workplace and supporting the interpersonal and intrapersonal capabilities of the nursing workforce. © 2012 Blackwell Publishing Ltd.

Integrated Medical Model – Chest Injury Model

Data.gov (United States)

National Aeronautics and Space Administration — The Exploration Medical Capability (ExMC) Element of NASA's Human Research Program (HRP) developed the Integrated Medical Model (IMM) to forecast the resources...

Career exploration behavior of Korean medical students

OpenAIRE

Hyejin An; Seung-Hee Lee

2017-01-01

Purpose This study is to analyze the effects of medical students? social support and career barriers on career exploration behavior mediated by career decision-making self-efficacy. Methods We applied the t-test to investigate the difference among the variables based on gender and admission types. Also, we performed path analysis to verify the effect of perceived career barriers and social support on career exploration behavior with career decision efficacy as a mediator. Results First, we no...

Exploring female GPs' perceptions about medical leadership.

Science.gov (United States)

Price, Karen; Clearihan, Lynette

2015-06-01

Women are increasingly entering the Australian general practice workforce. This study aims to explore female general practitioners' (GPs') perceptions of possible barriers to leadership and professional roles in the workforce. A purposive, convenience sample of 30 female GPs in active practice was approached in February, 2012. An anonymous, pa-per-based, semi-quantitative survey sought to identify participation and leadership confidence within general practice in a number of professional roles. The top two barriers participants identified for after-hours medical meetings were energy to attend and geographical location. For after-hours care, the top two barriers identified were energy and self-motivation. Few participants aspired to 'leadership' activities. 'Medical mentoring' was most likely to attract them into leadership. It is important female GPs' perspectives are explored in general practice. This small survey suggests further studies are needed in the importance of energy limitations and lack of self-confidence in restricting female GPs' capacity to fully engage in professional roles.

Production capabilities in US nuclear reactors for medical radioisotopes

Energy Technology Data Exchange (ETDEWEB)

Mirzadeh, S.; Callahan, A.P.; Knapp, F.F. Jr. (Oak Ridge National Lab., TN (United States)); Schenter, R.E. (Westinghouse Hanford Co., Richland, WA (United States))

1992-11-01

The availability of reactor-produced radioisotopes in the United States for use in medical research and nuclear medicine has traditionally depended on facilities which are an integral part of the US national laboratories and a few reactors at universities. One exception is the reactor in Sterling Forest, New York, originally operated as part of the Cintichem (Union Carbide) system, which is currently in the process of permanent shutdown. Since there are no industry-run reactors in the US, the national laboratories and universities thus play a critical role in providing reactor-produced radioisotopes for medical research and clinical use. The goal of this survey is to provide a comprehensive summary of these production capabilities. With the temporary shutdown of the Oak Ridge National Laboratory (ORNL) High Flux Isotope Reactor (HFIR) in November 1986, the radioisotopes required for DOE-supported radionuclide generators were made available at the Brookhaven National Laboratory (BNL) High Flux Beam Reactor (HFBR). In March 1988, however, the HFBR was temporarily shut down which forced investigators to look at other reactors for production of the radioisotopes. During this period the Missouri University Research Reactor (MURR) played an important role in providing these services. The HFIR resumed routine operation in July 1990 at 85 MW power, and the HFBR resumed operation in June 1991, at 30 MW power. At the time of the HFBR shutdown, there was no available comprehensive overview which could provide information on status of the reactors operating in the US and their capabilities for radioisotope production. The obvious need for a useful overview was thus the impetus for preparing this survey, which would provide an up-to-date summary of those reactors available in the US at both the DOE-funded national laboratories and at US universities where service irradiations are currently or expected to be conducted.

Production capabilities in US nuclear reactors for medical radioisotopes

International Nuclear Information System (INIS)

Mirzadeh, S.; Callahan, A.P.; Knapp, F.F. Jr.; Schenter, R.E.

1992-11-01

The availability of reactor-produced radioisotopes in the United States for use in medical research and nuclear medicine has traditionally depended on facilities which are an integral part of the US national laboratories and a few reactors at universities. One exception is the reactor in Sterling Forest, New York, originally operated as part of the Cintichem (Union Carbide) system, which is currently in the process of permanent shutdown. Since there are no industry-run reactors in the US, the national laboratories and universities thus play a critical role in providing reactor-produced radioisotopes for medical research and clinical use. The goal of this survey is to provide a comprehensive summary of these production capabilities. With the temporary shutdown of the Oak Ridge National Laboratory (ORNL) High Flux Isotope Reactor (HFIR) in November 1986, the radioisotopes required for DOE-supported radionuclide generators were made available at the Brookhaven National Laboratory (BNL) High Flux Beam Reactor (HFBR). In March 1988, however, the HFBR was temporarily shut down which forced investigators to look at other reactors for production of the radioisotopes. During this period the Missouri University Research Reactor (MURR) played an important role in providing these services. The HFIR resumed routine operation in July 1990 at 85 MW power, and the HFBR resumed operation in June 1991, at 30 MW power. At the time of the HFBR shutdown, there was no available comprehensive overview which could provide information on status of the reactors operating in the US and their capabilities for radioisotope production. The obvious need for a useful overview was thus the impetus for preparing this survey, which would provide an up-to-date summary of those reactors available in the US at both the DOE-funded national laboratories and at US universities where service irradiations are currently or expected to be conducted

Medical Optimization Network for Space Telemedicine Resources

Science.gov (United States)

Shah, R. V.; Mulcahy, R.; Rubin, D.; Antonsen, E. L.; Kerstman, E. L.; Reyes, D.

2017-01-01

INTRODUCTION: Long-duration missions beyond low Earth orbit introduce new constraints to the space medical system such as the inability to evacuate to Earth, communication delays, and limitations in clinical skillsets. NASA recognizes the need to improve capabilities for autonomous care on such missions. As the medical system is developed, it is important to have an ability to evaluate the trade space of what resources will be most important. The Medical Optimization Network for Space Telemedicine Resources was developed for this reason, and is now a system to gauge the relative importance of medical resources in addressing medical conditions. METHODS: A list of medical conditions of potential concern for an exploration mission was referenced from the Integrated Medical Model, a probabilistic model designed to quantify in-flight medical risk. The diagnostic and treatment modalities required to address best and worst-case scenarios of each medical condition, at the terrestrial standard of care, were entered into a database. This list included tangible assets (e.g. medications) and intangible assets (e.g. clinical skills to perform a procedure). A team of physicians working within the Exploration Medical Capability Element of NASA's Human Research Program ranked each of the items listed according to its criticality. Data was then obtained from the IMM for the probability of occurrence of the medical conditions, including a breakdown of best case and worst case, during a Mars reference mission. The probability of occurrence information and criticality for each resource were taken into account during analytics performed using Tableau software. RESULTS: A database and weighting system to evaluate all the diagnostic and treatment modalities was created by combining the probability of condition occurrence data with the criticalities assigned by the physician team. DISCUSSION: Exploration Medical Capabilities research at NASA is focused on providing a medical system to

Human Exploration Systems and Mobility Capability Roadmap Progress Review

Science.gov (United States)

Culbert, Chris; Taylor, Jeff

2005-01-01

Contents include the following: Capability Roadmap Team. Capability Description and Capability Breakdown Structure. Benefits of the Human Systems and Mobility Capability. Roadmap Process and Approach. Drivers and Assumptions for the whole team. Current State-of-the-Art, Assumptions and Requirements will be covered in the appropriate sections. Capability Presentations by Leads under Roadmap (Repeated for each capability under roadmap). Capability Description, Benefits, Current State-of-the-Art. Capability Requirements and Assumptions. Roadmap for Capability. Capability Readiness Level. Technology Readiness Level. Figures of Merit. Summary of Top Level Capability. Significant Technical Challenges. Summary and Forward Work.

Capability and Technology Performance Goals for the Next Step in Affordable Human Exploration of Space

Science.gov (United States)

Linne, Diane L.; Sanders, Gerald B.; Taminger, Karen M.

2015-01-01

The capability for living off the land, commonly called in-situ resource utilization, is finally gaining traction in space exploration architectures. Production of oxygen from the Martian atmosphere is called an enabling technology for human return from Mars, and a flight demonstration to be flown on the Mars 2020 robotic lander is in development. However, many of the individual components still require technical improvements, and system-level trades will be required to identify the best combination of technology options. Based largely on work performed for two recent roadmap activities, this paper defines the capability and technology requirements that will need to be achieved before this game-changing capability can reach its full potential.

Readiness for the Patient-Centered Medical Home: structural capabilities of Massachusetts primary care practices.

Science.gov (United States)

Friedberg, Mark W; Safran, Dana G; Coltin, Kathryn L; Dresser, Marguerite; Schneider, Eric C

2009-02-01

The Patient-Centered Medical Home (PCMH), a popular model for primary care reorganization, includes several structural capabilities intended to enhance quality of care. The extent to which different types of primary care practices have adopted these capabilities has not been previously studied. To measure the prevalence of recommended structural capabilities among primary care practices and to determine whether prevalence varies among practices of different size (number of physicians) and administrative affiliation with networks of practices. Cross-sectional analysis. One physician chosen at random from each of 412 primary care practices in Massachusetts was surveyed about practice capabilities during 2007. Practice size and network affiliation were obtained from an existing database. Presence of 13 structural capabilities representing 4 domains relevant to quality: patient assistance and reminders, culture of quality, enhanced access, and electronic health records (EHRs). Three hundred eight (75%) physicians responded, representing practices with a median size of 4 physicians (range 2-74). Among these practices, 64% were affiliated with 1 of 9 networks. The prevalence of surveyed capabilities ranged from 24% to 88%. Larger practice size was associated with higher prevalence for 9 of the 13 capabilities spanning all 4 domains (P < 0.05). Network affiliation was associated with higher prevalence of 5 capabilities (P < 0.05) in 3 domains. Associations were not substantively altered by statistical adjustment for other practice characteristics. Larger and network-affiliated primary care practices are more likely than smaller, non-affiliated practices to have adopted several recommended capabilities. In order to achieve PCMH designation, smaller non-affiliated practices may require the greatest investments.

Dynamic capabilities and innovation capabilities: The case of the ‘Innovation Clinic’

Directory of Open Access Journals (Sweden)

Fred Strønen

2017-01-01

Full Text Available In this explorative study, we investigate the relationship between dynamic capabilities and innovation capabilities. Dynamic capabilities are at the core of strategic management in terms of how firms can ensure adaptation to changing environments over time. Our paper follows two paths of argumentation. First, we review and discuss some major contributions to the theories on ordinary capabilities, dynamic capabilities, and innovation capabilities. We seek to identify different understandings of the concepts in question, in order to clarify the distinctions and relationships between dynamic capabilities and innovation capabilities. Second, we present a case study of the ’Innovation Clinic’ at a major university hospital, including four innovation projects. We use this case study to explore and discuss how dynamic capabilities can be extended, as well as to what extent innovation capabilities can be said to be dynamic. In our conclusion, we discuss the conditions for nurturing ‘dynamic innovation capabilities’ in organizations.

Exploring Factors Affecting Emergency Medical Services Staffs' Decision about Transporting Medical Patients to Medical Facilities.

Science.gov (United States)

Ebrahimian, Abbasali; Seyedin, Hesam; Jamshidi-Orak, Roohangiz; Masoumi, Gholamreza

2014-01-01

Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs' decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: "degree of perceived risk in EMS staffs and their patients." This theme consisted of two main categories: (1) patient's condition' and (2) the context of the EMS mission'. The patent's condition category emerged from "physical health statuses," "socioeconomic statuses," and "cultural background" subcategories. The context of the EMS mission also emerged from two subcategories of "characteristics of the mission" and EMS staffs characteristics'. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients' needs for transportation in a prehospital situation.

Exploring the tensions of being and becoming a medical educator.

Science.gov (United States)

Sethi, Ahsan; Ajjawi, Rola; McAleer, Sean; Schofield, Susie

2017-03-23

Previous studies have identified tensions medical faculty encounter in their roles but not specifically those with a qualification in medical education. It is likely that those with postgraduate qualifications may face additional tensions (i.e., internal or external conflicts or concerns) from differentiation by others, greater responsibilities and translational work against the status quo. This study explores the complex and multi-faceted tensions of educators with qualifications in medical education at various stages in their career. The data described were collected in 2013-14 as part of a larger, three-phase mixed-methods research study employing a constructivist grounded theory analytic approach to understand identity formation among medical educators. The over-arching theoretical framework for the study was Communities of Practice. Thirty-six educators who had undertaken or were undertaking a postgraduate qualification in medical education took part in semi-structured interviews. Participants expressed multiple tensions associated with both becoming and being a healthcare educator. Educational roles had to be juggled with clinical work, challenging their work-life balance. Medical education was regarded as having lower prestige, and therefore pay, than other healthcare career tracks. Medical education is a vast speciality, making it difficult as a generalist to keep up-to-date in all its areas. Interestingly, the graduates with extensive experience in education reported no fears, rather asserting that the qualification gave them job variety. This is the first detailed study exploring the tensions of educators with postgraduate qualifications in medical education. It complements and extends the findings of the previous studies by identifying tensions common as well as specific to active students and graduates. These tensions may lead to detachment, cynicism and a weak sense of identity among healthcare educators. Postgraduate programmes in medical education

Prototype Development of a Tradespace Analysis Tool for Spaceflight Medical Resources.

Science.gov (United States)

Antonsen, Erik L; Mulcahy, Robert A; Rubin, David; Blue, Rebecca S; Canga, Michael A; Shah, Ronak

2018-02-01

The provision of medical care in exploration-class spaceflight is limited by mass, volume, and power constraints, as well as limitations of available skillsets of crewmembers. A quantitative means of exploring the risks and benefits of inclusion or exclusion of onboard medical capabilities may help to inform the development of an appropriate medical system. A pilot project was designed to demonstrate the utility of an early tradespace analysis tool for identifying high-priority resources geared toward properly equipping an exploration mission medical system. Physician subject matter experts identified resources, tools, and skillsets required, as well as associated criticality scores of the same, to meet terrestrial, U.S.-specific ideal medical solutions for conditions concerning for exploration-class spaceflight. A database of diagnostic and treatment actions and resources was created based on this input and weighed against the probabilities of mission-specific medical events to help identify common and critical elements needed in a future exploration medical capability. Analysis of repository data demonstrates the utility of a quantitative method of comparing various medical resources and skillsets for future missions. Directed database queries can provide detailed comparative estimates concerning likelihood of resource utilization within a given mission and the weighted utility of tangible and intangible resources. This prototype tool demonstrates one quantitative approach to the complex needs and limitations of an exploration medical system. While this early version identified areas for refinement in future version development, more robust analysis tools may help to inform the development of a comprehensive medical system for future exploration missions.Antonsen EL, Mulcahy RA, Rubin D, Blue RS, Canga MA, Shah R. Prototype development of a tradespace analysis tool for spaceflight medical resources. Aerosp Med Hum Perform. 2018; 89(2):108-114.

Exploring emotional intelligence in a Caribbean medical school.

Science.gov (United States)

Sa, B; Baboolal, N; Williams, S; Ramsewak, S

2014-03-01

To explore the emotional intelligence (EI) in medical students in a Caribbean medical school and investigate its association with gender, age, year of study and ethnicity. A cross-sectional design using convenient sampling of 304 years two to five undergraduate medical students at the School of Medicine, the University of the West Indies (UWI), St Augustine campus, was conducted. The Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT-V2.0) was administered to test four branches of EI: perceiving emotions, facilitating thought, understanding emotions and managing emotions. Data were analysed using SPSS version 19. T-test, analysis of variance (ANOVA) and r (product moment correlation) were calculated to establish the effects of selected variables (gender, age, year of study and ethnicity) on total and sub-scales EI scores and tested against 0.05 and 0.01 significance levels. The total mean score for EI fell within the average according to MSCEIT standards. Gender analysis showed significantly higher scores for males and for younger age groups (maturity and emotional stability. It would be valuable to widen this study by including other UWI campuses and offshore medical schools in the Caribbean. This preliminary study examined a sample of medical students from a well-established Caribbean medical school. Since EI is considered to be important in the assessment and training of medical undergraduates, consideration should be given to introducing interventions aimed at increasing EI.

Capabilities for Strategic Adaptation

DEFF Research Database (Denmark)

Distel, Andreas Philipp

This dissertation explores capabilities that enable firms to strategically adapt to environmental changes and preserve competitiveness over time – often referred to as dynamic capabilities. While dynamic capabilities being a popular research domain, too little is known about what these capabiliti...

Nurses' experiences and perspectives on medication safety practices: an explorative qualitative study

NARCIS (Netherlands)

Smeulers, Marian; Onderwater, Astrid T.; van Zwieten, Myra C. B.; Vermeulen, Hester

2014-01-01

To explore nurses' experiences with and perspectives on preventing medication administration errors. Insight into nurses' experiences with and perspectives on preventing medication administration errors is important and can be utilised to tailor and implement safety practices. A qualitative

Exploring the Influence of Context on Feedback at Medical School: A Video-Ethnography Study

Science.gov (United States)

Urquhart, L. M.; Ker, J. S.; Rees, C. E.

2018-01-01

Feedback in medical education is complicated by the multiple contexts within which learning occurs. However, feedback research in medical education has typically focused on information provided by tutors to students with limited exploration of the influence of context. This research seeks to address this gap by exploring the influence of multiple…

Exploring Factors Affecting Emergency Medical Services Staffs’ Decision about Transporting Medical Patients to Medical Facilities

Directory of Open Access Journals (Sweden)

Abbasali Ebrahimian

2014-01-01

Full Text Available Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS staffs. So this study was performed to explore affecting factors in EMS staffs’ decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: “degree of perceived risk in EMS staffs and their patients.” This theme consisted of two main categories: (1 patient’s condition’ and (2 the context of the EMS mission’. The patent’s condition category emerged from “physical health statuses,” “socioeconomic statuses,” and “cultural background” subcategories. The context of the EMS mission also emerged from two subcategories of “characteristics of the mission” and EMS staffs characteristics’. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients’ needs for transportation in a prehospital situation.

Direct transport to a PCI-capable hospital is associated with improved survival after adult out-of-hospital cardiac arrest of medical aetiology.

Science.gov (United States)

McKenzie, Nicole; Williams, Teresa A; Ho, Kwok M; Inoue, Madoka; Bailey, Paul; Celenza, Antonio; Fatovich, Daniel; Jenkins, Ian; Finn, Judith

2018-05-02

To compare survival outcomes of adults with out-of-hospital cardiac arrest (OHCA) of medical aetiology directly transported to a percutaneous-coronary-intervention capable (PCI-capable) hospital (direct transport) with patients transferred to a PCI-capable hospital via another hospital without PCI services available (indirect transport) by emergency medical services (EMS). This retrospective cohort study used the St John Ambulance Western Australia OHCA Database and medical chart review. We included OHCA patients (≥18 years) admitted to any one of five PCI-capable hospitals in Perth between January 2012 and December 2015. Survival to hospital discharge (STHD) and survival up to 12-months after OHCA were compared between the direct and indirect transport groups using multivariable logistic and Cox-proportional hazards regression, respectively, while adjusting for so-called "Utstein variables" and other potential confounders. Of the 509 included patients, 404 (79.4%) were directly transported to a PCI-capable hospital and 105 (20.6%) transferred via another hospital to a PCI-capable hospital; 274/509 (53.8%) patients STHD and 253/509 (49.7%) survived to 12-months after OHCA. Direct transport patients were twice as likely to STHD (adjusted odds ratio 1.97, 95% confidence interval [CI] 1.13-3.43) than those transferred via another hospital. Indirect transport was also associated with a possible increased risk of death, up to 12-months, compared to direct transport (adjusted hazard ratio 1.36, 95% CI 1.00-1.84). Direct transport to a PCI-capable hospital for post-resuscitation care is associated with a survival advantage for adults with OHCA of medical aetiology. This has implications for EMS transport protocols for patients with OHCA. Copyright © 2018 Elsevier B.V. All rights reserved.

Security protection of DICOM medical images using dual-layer reversible watermarking with tamper detection capability.

Science.gov (United States)

Tan, Chun Kiat; Ng, Jason Changwei; Xu, Xiaotian; Poh, Chueh Loo; Guan, Yong Liang; Sheah, Kenneth

2011-06-01

Teleradiology applications and universal availability of patient records using web-based technology are rapidly gaining importance. Consequently, digital medical image security has become an important issue when images and their pertinent patient information are transmitted across public networks, such as the Internet. Health mandates such as the Health Insurance Portability and Accountability Act require healthcare providers to adhere to security measures in order to protect sensitive patient information. This paper presents a fully reversible, dual-layer watermarking scheme with tamper detection capability for medical images. The scheme utilizes concepts of public-key cryptography and reversible data-hiding technique. The scheme was tested using medical images in DICOM format. The results show that the scheme is able to ensure image authenticity and integrity, and to locate tampered regions in the images.

The Evolution of Medical Training Simulation in the U.S. Military.

Science.gov (United States)

Linde, Amber S; Kunkler, Kevin

2016-01-01

The United States has been at war since 2003. During that time, training using Medical Simulation technology has been developed and integrated into military medical training for combat medics, nurses and surgeons. Efforts stemming from the Joint Programmatic Committee-1 (JPC-1) Medical Simulation and Training Portfolio has allowed for the improvement and advancement in military medical training by focusing on research in simulation training technology in order to achieve this. Based upon lessons learned capability gaps have been identified concerning the necessity to validate and enhance combat medial training simulators. These capability gaps include 1) Open Source/Open Architecture; 2) Modularity and Interoperability; and 3) Material and Virtual Reality (VR) Models. Using the capability gaps, JPC-1 has identified important research endeavors that need to be explored.

Does a summative portfolio foster the development of capabilities such as reflective practice and understanding ethics? An evaluation from two medical schools.

Science.gov (United States)

O'Sullivan, Anthony J; Howe, Amanda C; Miles, Susan; Harris, Peter; Hughes, Chris S; Jones, Philip; Scicluna, Helen; Leinster, Sam J

2012-01-01

Portfolios need to be evaluated to determine whether they encourage students to develop in capabilities such as reflective practice and ethical judgment. The aims of this study were (i) to determine whether preparing a portfolio helps promote students' development in a range of capabilities including understanding ethical and legal principles, reflective practice and effective communication, and (ii) to determine to what extent the format of the portfolio affected the outcome by comparing the experiences of students at two different medical schools. A questionnaire was designed to evaluate undergraduate medical students' experiences of completing a portfolio at two medical schools. A total of 526 (45% response rate) students answered the on-line questionnaire. Students from both medical schools gave the highest ranking for the portfolio as a trigger for reflective practice. 63% of students agreed their portfolio helped them develop reflective practice skills (p portfolios helped them understand ethical and legal principles whereas 29% disagreed (p portfolio helped them to develop effective communication. Students perceive portfolio preparation as an effective learning tool for the development of capabilities such as understanding ethical and legal principles and reflective practice, whereas other capabilities such as effective communication require complementary techniques and other modes of assessment.

Exploring the potential use of augmented reality in medical education

OpenAIRE

Orraryd, Pontus

2017-01-01

Human anatomy is traditionally taught using textbooks and dissections. With the advent of computer graphics, using 3D applications have started to see much more use in medical educations around the world. Today, technology such as Augmented Reality and Virtual Reality are on everybody’s lips, and many are now curious what we can do with this new technology. This thesis explores how Augmented Reality can be used in medical education to teach human anatomy. Two application prototypes were devel...

Storyboard for the Medical System Concept of Operations for Mars Exploration Missions

Science.gov (United States)

Antonsen, Eric; Hailey, Melinda; Reyes, David; Rubin, David; Urbina, Michelle

2017-01-01

This storyboard conceptualizes one scenario of an integrated medical system during a Mars exploration mission. All content is for illustrative purposes only and neither defines nor implies system design requirement.

Organizational Strategic Learning Capability: Exploring the Dimensions

Science.gov (United States)

Moon, Hanna; Sejong, Wendy; Valentine, Tom

2017-01-01

Purpose: How to build and enhance the strategic learning capability (SLC) of an organization becomes crucial to both research and practice. This study was designed with the purpose to conceptualize SLC by translating and interpreting the related literature to develop empirical dimensions that could be tested and used in a survey instrument.…

Unpacking dynamic capability : a design perspective

NARCIS (Netherlands)

Mulders, D.E.M.; Romme, A.G.L.; Bøllingtoft, A.; Håkonsson, D.D.; Nielsen, J.F.; Snow, C.C; Ulhøi, J.

2009-01-01

This chapter reviews the dynamic capability literature to explore relationships between definition, operationalization, and measurement of dynamic capability. Subsequently, we develop a design-oriented approach toward dynamic capability that distinguishes between design rules, recurrent patterns of

Amartya Sen's Capability Approach and Education

Science.gov (United States)

Walker, Melanie

2005-01-01

The human capabilities approach developed by the economist Amartya Sen links development, quality of life and freedom. This article explores the key ideas in the capability approach of: capability, functioning, agency, human diversity and public participation in generating valued capabilities. It then considers how these ideas relate specifically…

Teaching medical students to express empathy by exploring patient emotions and experiences in standardized medical encounters.

Science.gov (United States)

Ruiz-Moral, Roger; Pérula de Torres, Luis; Monge, Diana; García Leonardo, Cristina; Caballero, Fernando

2017-09-01

To increase medical students' ability to detect contextual and emotional cues and to respond empathetically to patients. a training course in communication skills and patient-centered care with different teaching activities (didactic, reflective and interactive: workshops and encounters with simulated patients) was delivered to third-year medical students just before their clerkships. The program was evaluated by an external observer (OE) and simulated patients (SP) in 2 or 3 videotaped encounters. Students improved significantly from baseline to 3rd interview in all communicative skills and domains explored both in OE (32.4%) and SP (38.3%) measurement. At the end of the course students detected significantly more clues and made more empathetic expressions. The course seems to improve the ability of students to explore the illness experience, showing more empathy in a more genuine way. This was carried out in consultations lasting 10min. The program is effective and feasible to be applied as a regular formative activity. Further research is needed to assess whether this training program is applicable to students in more advanced educational levels and if it has any additional outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

Exploring the potential of video technologies for collaboration in emergency medical care

DEFF Research Database (Denmark)

Söderholm, Hanna M.; Sonnenwald, Diane H.; Manning, James E.

2008-01-01

conferencing techniques. This may be of benefit in diagnosing and treating patients in emergency situations where specialized medical expertise is not locally available. The experimental design and results concerning information behavior are presented in the article "Exploring the Potential of Video...

Exploring the Top-Cited and Most Influential Articles in Medical Education.

Science.gov (United States)

Azer, Samy A

2016-01-01

The citations received by a scientific publication have been used as a proxy measurement of scientific quality and in ranking researchers. Although these practices have been observed in several institutes, careful assessment of top-cited articles may provide more insight into exploring their characteristics. The aim of this study was to analyze the top-cited articles in medical education identified by Azer 2015 and explore the characteristics of these articles that can provide insight into their assessment. The most frequently cited articles identified by searching the Web of Science under the category "Education, Scientific Discipline" were included in the analysis. The following issues were further analyzed: 1) comparing the mean yearly citations received by articles published before the year 2000 and those published after, 2) assessing whether there was a correlation between the number of grants, number of authors, number of institutes, or number of countries involved and the number of citations received, 3) assessing the number of female representation in authorship, 4) assessing the representation of none-medical staff in the authorship, and 5) exploring any association between top authors identified and those who were awarded the Karolinska Institutet Prize for research in medical education. Although there was no correlation between the number of citations and the number of years since publications, the mean number of citations received by articles published before the year 2000 varied from zero to 18.2 ± 16.6, whereas for those published after the year 2000 the mean varied from 2.0 ± 2.1 to 35.3 ± 26.8. No correlation was found between the number of citations obtained and number of grants, number of authors, number of institutes, or number of countries involved. Females comprised 50% of the total number of authors. However, no correlation was found between the number of females in authorship and the number of citations obtained. Similarly, the number of

Nurses' experiences and perspectives on medication safety practices: an explorative qualitative study.

Science.gov (United States)

Smeulers, Marian; Onderwater, Astrid T; van Zwieten, Myra C B; Vermeulen, Hester

2014-04-01

To explore nurses' experiences with and perspectives on preventing medication administration errors. Insight into nurses' experiences with and perspectives on preventing medication administration errors is important and can be utilised to tailor and implement safety practices. A qualitative interview study of 20 nurses in an academic medical centre was conducted between March and December of 2011. Three themes emerged from this study: (1) nurses' roles and responsibilities in medication safety: aside from safe preparation and administration, the clinical reasoning of nurses is essential for medication safety; (2) nurses' ability to work safely: knowledge of risks and nurses' work circumstances influence their ability to work safely; and (3) nurses' acceptance of safety practices: advantages, feasibility and appropriateness are important incentives for acceptance of a safety practice. Nurses' experiences coincide with the assumption that they are in a pre-eminent position to enable safe medication management; however, their ability to adequately perform this role depends on sufficient knowledge to assess the risks of medication administration and on the circumstances in which they work. Safe medication management requires a learning climate and professional practice environment that enables further development of professional nursing skills and knowledge. © 2014 John Wiley & Sons Ltd.

Exploring the impact of dynamic capabilities on sustainable supply chain firm's performance using Grey-Analytical Hierarchy Process

DEFF Research Database (Denmark)

Govindan, Kannan; Mathivathanan, Deepak; Haq, A. Noorul

2017-01-01

Dynamic capabilities (DCs) are the inherent capabilities developed by firms through the implementation of Sustainable Supply Chain practices. These DCs serve as a backbone for the firms to achieve competitive advantages in contemporary ever-changing markets. The present study focuses on exploring...... industrial managers to identify specific influential DCs for each performance measure category by overcoming the limitations of few experts through the application of the grey multi criteria decision making system. Identifying and prioritizing performance-specific DCs allow sustainable supply chain oriented...... performance measures identified from the literature. First, through a questionnaire survey with industrial experts from south India as respondents, the initial list of 77 DCs is confined to a list of 40 essential DCs. Second, the shortlisted 40 DCs are grouped under six performance measures; a logical...

Exploration of a capability-focused aerospace system of systems architecture alternative with bilayer design space, based on RST-SOM algorithmic methods.

Science.gov (United States)

Li, Zhifei; Qin, Dongliang; Yang, Feng

2014-01-01

In defense related programs, the use of capability-based analysis, design, and acquisition has been significant. In order to confront one of the most challenging features of a huge design space in capability based analysis (CBA), a literature review of design space exploration was first examined. Then, in the process of an aerospace system of systems design space exploration, a bilayer mapping method was put forward, based on the existing experimental and operating data. Finally, the feasibility of the foregoing approach was demonstrated with an illustrative example. With the data mining RST (rough sets theory) and SOM (self-organized mapping) techniques, the alternative to the aerospace system of systems architecture was mapping from P-space (performance space) to C-space (configuration space), and then from C-space to D-space (design space), respectively. Ultimately, the performance space was mapped to the design space, which completed the exploration and preliminary reduction of the entire design space. This method provides a computational analysis and implementation scheme for large-scale simulation.

Perspectives of healthcare practitioners: An exploration of interprofessional communication using electronic medical records.

Science.gov (United States)

Bardach, Shoshana H; Real, Kevin; Bardach, David R

2017-05-01

Contemporary state-of-the-art healthcare facilities are incorporating technology into their building design to improve communication and patient care. However, technological innovations may also have unintended consequences. This study seeks to better understand how technology influences interprofessional communication within a hospital setting based in the United States. Nine focus groups were conducted including a range of healthcare professions. The focus groups explored practitioners' experiences working on two floors of a newly designed hospital and included questions about the ways in which technology shaped communication with other healthcare professionals. All focus groups were recorded, transcribed, and coded to identify themes. Participant responses focused on the electronic medical record, and while some benefits of the electronic medical record were discussed, participants indicated use of the electronic medical record has resulted in a reduction of in-person communication. Different charting approaches resulted in barriers to communication between specialties and reduced confidence that other practitioners had received one's notes. Limitations in technology-including limited computer availability, documentation complexity, and sluggish sign-in processes-also were identified as barriers to effective and timely communication between practitioners. Given the ways in which technology shapes interprofessional communication, future research should explore how to create standardised electronic medical record use across professions at the optimal level to support communication and patient care.

Bayesian Analysis for Risk Assessment of Selected Medical Events in Support of the Integrated Medical Model Effort

Science.gov (United States)

Gilkey, Kelly M.; Myers, Jerry G.; McRae, Michael P.; Griffin, Elise A.; Kallrui, Aditya S.

2012-01-01

The Exploration Medical Capability project is creating a catalog of risk assessments using the Integrated Medical Model (IMM). The IMM is a software-based system intended to assist mission planners in preparing for spaceflight missions by helping them to make informed decisions about medical preparations and supplies needed for combating and treating various medical events using Probabilistic Risk Assessment. The objective is to use statistical analyses to inform the IMM decision tool with estimated probabilities of medical events occurring during an exploration mission. Because data regarding astronaut health are limited, Bayesian statistical analysis is used. Bayesian inference combines prior knowledge, such as data from the general U.S. population, the U.S. Submarine Force, or the analog astronaut population located at the NASA Johnson Space Center, with observed data for the medical condition of interest. The posterior results reflect the best evidence for specific medical events occurring in flight. Bayes theorem provides a formal mechanism for combining available observed data with data from similar studies to support the quantification process. The IMM team performed Bayesian updates on the following medical events: angina, appendicitis, atrial fibrillation, atrial flutter, dental abscess, dental caries, dental periodontal disease, gallstone disease, herpes zoster, renal stones, seizure, and stroke.

Remediation of at-risk medical students: theory in action

OpenAIRE

Winston, K.A.; Vleuten, C.P.M. van der; Scherpbier, A.J.J.A.

2013-01-01

BACKGROUND: Previous work has shown that a programme that draws on a blend of theories makes a positive difference to outcomes for students who fail and repeat their first semester at medical school. Exploration of student and teacher perspectives revealed that remediation of struggling medical students can be achieved through a cognitive apprenticeship within a small community of inquiry. This community needs expert teachers capable of performing a unique combination of roles (facilitator, n...

Exploring medical identity theft.

Science.gov (United States)

Mancilla, Desla; Moczygemba, Jackie

2009-09-16

The crime of medical identity theft is a growing concern in healthcare institutions. A mixed-method study design including a two-stage electronic survey, telephone survey follow-up, and on-site observations was used to evaluate current practices in admitting and registration departments to reduce the occurrence of medical identity theft. Survey participants were chief compliance officers in acute healthcare organizations and members of the Health Care Compliance Association. Study results indicate variance in whether or how patient identity is confirmed in healthcare settings. The findings of this study suggest that information systems need to be designed for more efficient identity management. Admitting and registration staff must be trained, and compliance with medical identity theft policies and procedures must be monitored. Finally, biometric identity management solutions should be considered for stronger patient identification verification.

Integrated Medical Model Overview

Science.gov (United States)

Myers, J.; Boley, L.; Foy, M.; Goodenow, D.; Griffin, D.; Keenan, A.; Kerstman, E.; Melton, S.; McGuire, K.; Saile, L.;

On the utility of 3D hand cursors to explore medical volume datasets with a touchless interface.

Science.gov (United States)

Lopes, Daniel Simões; Parreira, Pedro Duarte de Figueiredo; Paulo, Soraia Figueiredo; Nunes, Vitor; Rego, Paulo Amaral; Neves, Manuel Cassiano; Rodrigues, Pedro Silva; Jorge, Joaquim Armando

2017-08-01

Analyzing medical volume datasets requires interactive visualization so that users can extract anatomo-physiological information in real-time. Conventional volume rendering systems rely on 2D input devices, such as mice and keyboards, which are known to hamper 3D analysis as users often struggle to obtain the desired orientation that is only achieved after several attempts. In this paper, we address which 3D analysis tools are better performed with 3D hand cursors operating on a touchless interface comparatively to a 2D input devices running on a conventional WIMP interface. The main goals of this paper are to explore the capabilities of (simple) hand gestures to facilitate sterile manipulation of 3D medical data on a touchless interface, without resorting on wearables, and to evaluate the surgical feasibility of the proposed interface next to senior surgeons (N=5) and interns (N=2). To this end, we developed a touchless interface controlled via hand gestures and body postures to rapidly rotate and position medical volume images in three-dimensions, where each hand acts as an interactive 3D cursor. User studies were conducted with laypeople, while informal evaluation sessions were carried with senior surgeons, radiologists and professional biomedical engineers. Results demonstrate its usability as the proposed touchless interface improves spatial awareness and a more fluent interaction with the 3D volume than with traditional 2D input devices, as it requires lesser number of attempts to achieve the desired orientation by avoiding the composition of several cumulative rotations, which is typically necessary in WIMP interfaces. However, tasks requiring precision such as clipping plane visualization and tagging are best performed with mouse-based systems due to noise, incorrect gestures detection and problems in skeleton tracking that need to be addressed before tests in real medical environments might be performed. Copyright © 2017 Elsevier Inc. All rights reserved.

Physician capability to electronically exchange clinical information, 2011.

Science.gov (United States)

Patel, Vaishali; Swain, Matthew J; King, Jennifer; Furukawa, Michael F

2013-10-01

To provide national estimates of physician capability to electronically share clinical information with other providers and to describe variation in exchange capability across states and electronic health record (EHR) vendors using the 2011 National Ambulatory Medical Care Survey Electronic Medical Record Supplement. Survey of a nationally representative sample of nonfederal office-based physicians who provide direct patient care. The survey was administered by mail with telephone follow-up and had a 61% weighted response rate. The overall sample consisted of 4326 respondents. We calculated estimates of electronic exchange capability at the national and state levels, and applied multivariate analyses to examine the association between the capability to exchange different types of clinical information and physician and practice characteristics. In 2011, 55% of physicians had computerized capability to send prescriptions electronically; 67% had the capability to view lab results electronically; 42% were able to incorporate lab results into their EHR; 35% were able to send lab orders electronically; and, 31% exchanged patient clinical summaries with other providers. The strongest predictor of exchange capability is adoption of an EHR. However, substantial variation exists across geography and EHR vendors in exchange capability, especially electronic exchange of clinical summaries. In 2011, a majority of office-based physicians could exchange lab and medication data, and approximately one-third could exchange clinical summaries with patients or other providers. EHRs serve as a key mechanism by which physicians can exchange clinical data, though physicians' capability to exchange varies by vendor and by state.

What is nature capable of? Evidence, ontology and speculative medical humanities.

Science.gov (United States)

Savransky, Martin; Rosengarten, Marsha

2016-09-01

Expanding on the recent call for a 'critical medical humanities' to intervene in questions of the ontology of health, this article develops a what we call a 'speculative' orientation to such interventions in relation to some of the ontological commitments on which contemporary biomedical cultures rest. We argue that crucial to this task is an approach to ontology that treats it not as a question of first principles, but as a matter of the consequences of the images of nature that contemporary biomedical research practices espouse when they make claims to evidence, as well as the possible consequences of imagining different worlds in which health and disease processes partake. By attending to the implicit ontological assumptions involved in the method par excellence of biomedical research, namely the randomised controlled trial (RCT), we argue that the mechanistic ontology that tacitly informs evidence-based biomedical research simultaneously authorises a series of problematic consequences for understanding and intervening practically in the concrete realities of health. As a response, we develop an alternative ontological proposition that regards processes of health and disease as always situated achievements. We show that, without disqualifying RCT-based evidence, such a situated ontology enables one to resist the reduction of the realities of health and disease to biomedicine's current forms of explanation. In so doing, we call for medical humanities scholars to actively engage in the speculative question of what nature may be capable of. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Exploring stakeholders' views of medical education research priorities: a national survey.

Science.gov (United States)

Dennis, Ashley A; Cleland, Jennifer A; Johnston, Peter; Ker, Jean S; Lough, Murray; Rees, Charlotte E

2014-11-01

Setting research priorities is important when exploring complex issues with limited resources. Only two countries (Canada and New Zealand) have previously conducted priority-setting exercises for medical education research (MER). This study aimed to identify the views of multiple stakeholders on MER priorities in Scotland. This study utilised a two-stage design to explore the views of stakeholders across the medical education continuum using online questionnaires. In Stage 1, key informants outlined their top three MER priorities and justified their choices. In Stage 2, participants rated 21 topics generated in Stage 1 according to importance and identified or justified their top priorities. A combination of qualitative (i.e. framework analysis) and quantitative (e.g. exploratory factor analysis) data analyses were employed. Views were gathered from over 1300 stakeholders. A total of 21 subthemes (or priority areas) identified in Stage 1 were explored further in Stage 2. The 21 items loaded onto five factors: the culture of learning together in the workplace; enhancing and valuing the role of educators; curriculum integration and innovation; bridging the gap between assessment and feedback, and building a resilient workforce. Within Stage 2, the top priority subthemes were: balancing conflicts between service and training; providing useful feedback; promoting resiliency and well-being; creating an effective workplace learning culture; selecting and recruiting doctors to reflect need, and ensuring that curricula prepare trainees for practice. Participant characteristics were related to the perceived importance of the factors. Finally, five themes explaining why participants prioritised items were identified: patient safety; quality of care; investing for the future; policy and political agendas, and evidence-based education. This study indicates that, across the spectrum of stakeholders and geography, certain MER priorities are consistently identified. These

The Pathway to a Safe and Effective Spaceflight Medication Formulary: Expert Review Panel Recommendations

Science.gov (United States)

Daniels, V. R.; Bayuse, T. M.; Mulcahy, R. A.; McGuire, R. K. M.; Antonsen, E. L.

2018-01-01

Exploration spaceflight poses several challenges to the provision of a comprehensive medication formulary. This formulary must accommodate the size and space limitations of the spacecraft, while addressing individual medication needs and preferences of the crew, consequences of a degrading inventory over time, the inability to resupply used or expired medications, and the need to forecast the best possible medication candidates to treat conditions that may occur. The Exploration Medical Capability (ExMC) Element's Pharmacy Project Team has developed a research plan (RP) that is focused on evidence-based models and theories as well as new diagnostic tools, treatments, or preventive measures aimed to ensure an available, safe, and effective pharmacy sufficient to manage potential medical threats during exploration spaceflight. Here, we will discuss the ways in which the ExMC Pharmacy Project Team pursued expert evaluation and guidance, and incorporated acquired insight into an achievable research pathway, reflected in the revised RP.

Leadership and followership in the healthcare workplace: exploring medical trainees' experiences through narrative inquiry

OpenAIRE

Gordon, Lisi J.; Rees, Charlotte E.; Ker, Jean S.; Cleland, Jennifer

2015-01-01

This research was part of LJG’s PhD research which was generously funded by NHS Education for Scotland through SMERC. OBJECTIVES: To explore medical trainees' experiences of leadership and followership in the interprofessional healthcare workplace. DESIGN: A qualitative approach using narrative interviewing techniques in 11 group and 19 individual interviews with UK medical trainees. SETTING: Multisite study across four UK health boards. PARTICIPANTS: Through maximum variation sampling, 65...

Taking a Capability Approach to Technology and Its Design : A Philosophical Exploration

NARCIS (Netherlands)

Oosterlaken, E.T.

2013-01-01

What people are realistically able to do and be in their lives, their capabilities, are of central moral importance according to the capability approach (CA) of Amartya Sen and Martha Nussbaum. Examples are the capabilities to be healthy or to be part of a community. The CA has become an influential

Taiwanese Medical Students' Narratives of Intercultural Professionalism Dilemmas: Exploring Tensions between Western Medicine and Taiwanese Culture

Science.gov (United States)

Ho, Ming-Jung; Gosselin, Katherine; Chandratilake, Madawa; Monrouxe, Lynn V.; Rees, Charlotte E.

2017-01-01

In an era of globalization, cultural competence is necessary for the provision of quality healthcare. Although this topic has been well explored in non-Western cultures within Western contexts, the authors explore how Taiwanese medical students trained in Western medicine address intercultural professionalism dilemmas related to tensions between…

Networking capability and new product development

NARCIS (Netherlands)

Mu, J.; Di Benedetto, A.C.

2012-01-01

Current research on network theory remains largely focused on structures and outcomes without exploring the capability that firms need to build efficient and effective networks to their advantage. In this paper, we take a networking capability view in studying inter-firm relationships. We assume

Exploring the practical themes for medical education social accountability in Iran.

Science.gov (United States)

Ahmady, Soleiman; Akbari Lakeh, Maryam

2015-01-01

The purpose of this paper is to explore themes for enhancing socially accountability in medical education. Medical education in Iran experience new challenges due to the enormous influence of changes in technology, development of new methods of teaching and learning, student requirements, patient management, financial credit constraints, and social and economic developments. For responding to these, use of strategic thinking in order to make appropriate decisions is the only solution. Strategic plans need to formulate practical guides which can help accountable to people's reasonable expectations. For this qualitative study, along with the 14(th)national conference on Medical Education in Iran, the opinions of experts were obtained during seven expert panels' group discussions, each lasting four hours and including 10 participants. Data were collected by audiotapes, which were then transcribed. Data analyzed using a thematic content analysis approach. Peer and member checking during analysis and data triangulation from other recent studies were used to increase the findings' trustworthiness. Among more than hundred meaning units groups identified the following eight main themes as affecting the social accountable medical education in Iran: organization of responsive education councils; development of community based courses; development in field training; organization of educational processes; homogeneity in educational rules and regulations; budget management, educational outcomes; educational programs in departments and groups. This study have found the main themes that might affecting social accountable medical education in Iran, where Iranian policymakers should consider those when plan to make changes in medical education and could potentially adopt the proven useful policies and strategies of other countries.

Educational Debt in the Context of Career Planning: A Qualitative Exploration of Medical Student Perceptions.

Science.gov (United States)

Phillips, Julie P; Wilbanks, Deana M; Salinas, Diana F; Doberneck, Diane M

2016-01-01

Phenomenon: Medical students in the United States face increasing educational debt because medical education costs have risen while public investment in higher education has declined. Contemporary students borrow more money and accumulate debt far surpassing that of previous generations of physicians, and both interest rates and terms of loan repayment have changed significantly in the last decade. As a result, the experiences of medical students differ from the experiences of physician educators. Little is known about how contemporary medical students view their debt in the context of career planning. Understanding contemporary U.S. medical students' lived experiences of educational debt is important, because high debt levels may affect medical students' well-being and professional development. The study's purpose was to explore contemporary students' views of their debt in the context of career planning. In 2012, 2nd-year medical students enrolled in a health policy course at one medical school were invited to write an essay about how debt influences their career choices. The authors analyzed 132 essays using immersion and crystallization and iterative, team-based coding. Code-recode strategies, member checking, and reflexivity ensured validity and rigor. Three themes emerged about the meaning of debt: debt symbolizes lack of social investment, debt reinforces a sense of entitlement, and debt is a collective experience. Four approaches to debt management emerged: anticipation, avoidance, acceptance, and disempowerment. Insights: Medical students' views of debt are more complex than previously reported. Medical educators should recognize that many students experience debt as a stressor, acknowledge students' emotions about debt, and invite discussion about the culture of entitlement in medical education and how this culture affects students' professionalism. At the same time, educators should emphasize that students have many repayment options and that regardless

Predictive Psychiatric Genetic Testing in Minors: An Exploration of the Non-Medical Benefits.

Science.gov (United States)

Manzini, Arianna; Vears, Danya F

2018-03-01

Predictive genetic testing for susceptibility to psychiatric conditions is likely to become part of standard practice. Because the onset of most psychiatric diseases is in late adolescence or early adulthood, testing minors could lead to early identification that may prevent or delay the development of these disorders. However, due to their complex aetiology, psychiatric genetic testing does not provide the immediate medical benefits that current guidelines require for testing minors. While several authors have argued non-medical benefits may play a crucial role in favour of predictive testing for other conditions, little research has explored such a role in psychiatric disorders. This paper outlines the potential non-medical benefits and harms of psychiatric genetic testing in minors in order to consider whether the non-medical benefits could ever make such testing appropriate. Five non-medical themes arise in the literature: psychological impacts, autonomy/self-determination, implications of the biomedical approach, use of financial and intellectual resources, and discrimination. Non-medical benefits were prominent in all of them, suggesting that psychiatric genetic testing in minors may be appropriate in some circumstances. Further research needs to empirically assess these potential non-medical benefits, incorporate minors in the debate, and include normative reflection to evaluate the very purposes and motivations of psychiatric genetic testing in minors.

Choosing a New Telephone System for Your Medical Practice.

Science.gov (United States)

Metherell, Brian

2016-01-01

E-mail may rule the world in other types of businesses, but for medical practices, the telephone remains the primary mode of communication with patients, specialists, and pharmacies. From making appointments to calling in prescriptions, telephones are essential to patient care. With technology changing very quickly and new capabilities coming into the medical practice, such as telemedicine and Skype, you need to know your options when choosing a new telephone system. The possibilities include on-site, cloud, and hybrid networked solutions. A wide variety of features and capabilities are available, from dozens of vendors. Of course, no matter what telephone solution you choose, you must meet regulatory compliance, particularly HIPAA, and Payment Card Industry Data Security Standard if you take credit cards. And it has to be affordable, reliable, and long lasting. This article explores what medical practices need to know when choosing a new business telephone system in order to find the right solutions for their businesses.

Exploring the implications of the influence of organisational culture on work-life balance practices: evidence from Nigerian medical doctors

OpenAIRE

Adisa, Toyin Ajibade; Modi, Chima; Osabutey, Ellis L. C.

2017-01-01

Purpose - Whilst significant evidence of western work-life balance (WLB) challenges exists, studies that explore Sub-Saharan Africa (SSA) are scarce. This article explores how organisational culture in Nigerian medical organisations influences doctors’ WLB and examines the implications of supportive and unsupportive cultures on doctors’ WLB. \\ud \\ud Methodology - The paper uses qualitative data gleaned from semi-structured interviews of 60 medical doctors across the six geo-political zones of...

CASL Dakota Capabilities Summary

Energy Technology Data Exchange (ETDEWEB)

Adams, Brian M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Simmons, Chris [Univ. of Texas, Austin, TX (United States); Williams, Brian J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2017-10-10

The Dakota software project serves the mission of Sandia National Laboratories and supports a worldwide user community by delivering state-of-the-art research and robust, usable software for optimization and uncertainty quantification. These capabilities enable advanced exploration and riskinformed prediction with a wide range of computational science and engineering models. Dakota is the verification and validation (V&V) / uncertainty quantification (UQ) software delivery vehicle for CASL, allowing analysts across focus areas to apply these capabilities to myriad nuclear engineering analyses.

A mixed methods exploration of family involvement in medical care for older adults with serious mental illness.

Science.gov (United States)

Aschbrenner, Kelly A; Pepin, Renee; Mueser, Kim T; Naslund, John A; Rolin, Stephanie A; Faber, Marjan J; Bartels, Stephen J

2014-01-01

Many older persons with serious mental illness (SMI) suffer from high rates of comorbid medical conditions. Although families play a critical role in psychiatric illness management among adults with SMI, their contributions to improving health outcomes in this population has received little attention. This study explored family involvement in medical care for older adults with SMI. This mixed methods study involved analysis of quantitative data collected from older adults with SMI and cardiovascular risk (n = 28) participating in a pilot study of an intervention designed to improve patient-centered primary care augmented by qualitative interviews with their relatives (n = 13) to explore family involvement in medical care. Approximately 89% of older adults with SMI reported family involvement in at least one aspect of their medical care (e.g., medication reminders, medical decision making). However, many family members reported that they were rarely involved in their relative's medical visits, and most did not perceive a need to be involved during routine care. Family members identified obesity as their relative's primary health concern and many wanted guidance from providers on effective strategies for supporting weight loss. Although many family members did not perceive a need to be involved in their relative's routine medical visits, they expressed interest in talking with providers about how to help their relative change unhealthy behaviors. Educating patients, families, and providers about the potential benefits of family involvement in medical care, including routine medical visits for persons with SMI and cardiovascular health risk may promote patient- and family-centered collaboration in this high-risk population.

Minors' rights in medical decision making.

Science.gov (United States)

Hickey, Kathryn

2007-01-01

In the past, minors were not considered legally capable of making medical decisions and were viewed as incompetent because of their age. The authority to consent or refuse treatment for a minor remained with a parent or guardian. This parental authority was derived from the constitutional right to privacy regarding family matters, common law rule, and a general presumption that parents or guardians will act in the best interest of their incompetent child. However, over the years, the courts have gradually recognized that children younger than 18 years who show maturity and competence deserve a voice in determining their course of medical treatment. This article will explore the rights and interests of minors, parents, and the state in medical decision making and will address implications for nursing administrators and leaders.

A grounded exploration of the dimensions of managerial capability: A preliminary study of top Australian pharmacist owner-managers.

Science.gov (United States)

Woods, Phillip; Gapp, Rod; King, Michelle A

2015-01-01

Australian community pharmacies are experiencing challenges, including government prescription pricing reform and a dramatically increasing competitive environment. Enacting appropriate responsive actions requires capable pharmacy managers. 'Capability' implies managing effectively in the present, but with unknown or emerging contexts and with new problems. A conceptual understanding of managerial capability as practiced by pharmacist owner-managers is unavailable in the literature. This research aimed to address the question: How can we understand managerial capability in relation to effective community pharmacy management? The study's objective was to develop preliminary theoretical departure points for continuing research responding to the research question. The objective was approached by exploring how 5 top Australian pharmacy owner-managers accomplish the management of their businesses in a changing business environment. Qualitative research methods were employed to develop a social process perspective of how the managers enact their management practices. In-depth semi-structured life-world interviews were undertaken as the major method of data collection. Interview text thematic analysis was carried out identifying rich conceptual properties and dimensions, which 'dimensionalized' 3 key integrated categories. The findings show how the managers are immersed in their business, managerial and personal practices in a holistic and relational manner. Managerial processes, reported through three conceptual categories, their properties and dimensions, reveal the highly situational nature of the reality the managers were experiencing, including their need to express their personal/professional identity. The properties and dimensions of the category 'learning generatively' in particular, reveal how the pharmacy owner-managers shape their business activities and their emerging context as time passes. The preliminary interpretive view of managerial capability describes

Exploring a motivation of medical staff.

Science.gov (United States)

Goncharuk, Anatoliy G

2018-06-08

This paper aims to identify the true motivators (needs) of medical staff, compare them with the current labor incentives, and detect possible differences in motivators for main groups of medical staff. Observing personnel of 5 hospitals and students of the medical institute by special questionnaires, the author confirmed the hypothesis of different motivators for groups of medical staff with different ages, professions, and gender. The author used special questionnaires to collect the data. Study results confirmed the hypothesis of different motivators for groups of medical staff with different ages, professions, and gender. The author also found significant differences between the motivation of Ukrainian health workers and their colleagues from other countries. The main conclusion is that no matter how we would like to satisfy gender and age equality, all people are individual and what is good for an elderly male doctor cannot be acceptable for a young female nurse. Therefore, forming the motivation system for employees of medical institutions, it is necessary to take into account the age, gender, professions, and other characteristics of each employee. In this way, we can achieve the highest health-care performance. Copyright © 2018 John Wiley & Sons, Ltd.

Potential Applications of Modularity to Enable a Deep Space Habitation Capability for Future Human Exploration Beyond Low-Earth Orbit

Science.gov (United States)

Simon, Matthew A.; Toups, Larry; Smitherman, David

2012-01-01

Evaluating preliminary concepts of a Deep Space Habitat (DSH) enabling long duration crewed exploration of asteroids, the Moon, and Mars is a technically challenging problem. Sufficient habitat volumes and equipment, necessary to ensure crew health and functionality, increase propellant requirements and decrease launch flexibility to deliver multiple elements on a single launch vehicle; both of which increase overall mission cost. Applying modularity in the design of the habitat structures and subsystems can alleviate these difficulties by spreading the build-up of the overall habitation capability across several smaller parts. This allows for a more flexible habitation approach that accommodates various crew mission durations and levels of functionality. This paper provides a technical analysis of how various modular habitation approaches can impact the parametric design of a DSH with potential benefits in mass, packaging volume, and architectural flexibility. This includes a description of the desired long duration habitation capability, the definition of a baseline model for comparison, a small trade study to investigate alternatives, and commentary on potentially advantageous configurations to enable different levels of habitability. The approaches investigated include modular pressure vessel strategies, modular subsystems, and modular manufacturing approaches to habitat structure. The paper also comments upon the possibility of an integrated habitation strategy using modular components to create all short and long duration habitation elements required in the current exploration architectures.

Managing Complexity: Exploring Decision Making on Medication by Young Adults with ADHD.

Science.gov (United States)

Druedahl, Louise C; Kälvemark Sporrong, Sofia

2018-04-19

Attention-deficit hyperactivity disorder (ADHD) causes difficulties with hyperactivity, impulsivity and inattention. Treatment of ADHD includes both medication and non-pharmacological options. Knowledge of treatment preferences by young adults with ADHD is sparse. The objective of this study was to explore the beliefs and experiences of young adults with ADHD related to their medication treatment decisions. Data were collected in Denmark in 2016 through a focus group and individual in-depth interviews. Conventional content analysis was used. Ten young adults with ADHD (22-to 29-year-old) participated. Three major themes were identified: (1) the patient’s right to choose concerning ADHD medicine; (2) the patient’s decision of whether or not to treat ADHD with medication; and (3) factors affecting the patient’s decision on whether to take ADHD medication or not. The latter theme contained 15 factors, which were distributed across three levels: individual, between-individuals, and societal. The dominant factors were increasing quality of life and improving oneself e.g., improving social skills. For counselling at the pharmacy and by prescribers, it is important to be aware of the different factors that affect young adult patients’ decisions on whether to take ADHD medication or not. This knowledge will aid to understand reasons for non-adherence and to determine appropriate treatment for the individual patient.

Space Communications Capability Roadmap Interim Review

Science.gov (United States)

Spearing, Robert; Regan, Michael

2005-01-01

Contents include the following: Identify the need for a robust communications and navigation architecture for the success of exploration and science missions. Describe an approach for specifying architecture alternatives and analyzing them. Establish a top level architecture based on a network of networks. Identify key enabling technologies. Synthesize capability, architecture and technology into an initial capability roadmap.

Exploring the resource and capabilities of food related enterprises in ...

African Journals Online (AJOL)

Agribotix GCS 068

Specifically, the two case studies illustrate the capabilities of business owners to identify assets at their ...... Strategic management and competitive advantage: Concepts .... Journal of Contemporary Hospitality Management 8(6), 427-436.

“We Routinely Borrow to Survive”: Exploring the Financial Capability of Income-Poor People in India.

Science.gov (United States)

Banerjee, Mahasweta M

2016-10-01

A lack of financial capability—financial opportunities and abilities—and poverty are highly interlinked. Over 65 percent of people in India are excluded from any financial services. This article explores income-poor Indians’ experiences with financial capability through a qualitative study. Purposive sampling was used to collect data from 658 individuals, through focus groups (n = 566) and face-to-face interviews (n = 92). Findings show that 97 percent of respondents had the opportunity to earn an income, and 55 percent earned through financial inclusion programs, but 87 percent of respondents earned less than U.S. $2 a day. Although almost all saved and needed to borrow, 46 percent were eligible for formal savings and only 23 percent for formal loans. Financial abilities or knowledge and skills related to income, savings, and loans were higher among the few who had a stable income or had medium and high income in relation to those who had unstable and low income. Respondents experienced many challenges with their financial capabilities, including borrowing to save, fearing formal loans, and lacking clarity about loan and interest rate; banks miscalculating interest rates; and political parties influencing access to loans. Implications for social policy and social work practice are discussed.

Assessing organizational readiness for depression care quality improvement: relative commitment and implementation capability.

Science.gov (United States)

Rubenstein, Lisa V; Danz, Marjorie S; Crain, A Lauren; Glasgow, Russell E; Whitebird, Robin R; Solberg, Leif I

2014-12-02

Depression is a major cause of morbidity and cost in primary care patient populations. Successful depression improvement models, however, are complex. Based on organizational readiness theory, a practice's commitment to change and its capability to carry out the change are both important predictors of initiating improvement. We empirically explored the links between relative commitment (i.e., the intention to move forward within the following year) and implementation capability. The DIAMOND initiative administered organizational surveys to medical and quality improvement leaders from each of 83 primary care practices in Minnesota. Surveys preceded initiation of activities directed at implementation of a collaborative care model for improving depression care. To assess implementation capability, we developed composites of survey items for five types of organizational factors postulated to be collaborative care barriers and facilitators. To assess relative commitment for each practice, we averaged leader ratings on an identical survey question assessing practice priorities. We used multivariable regression analyses to assess the extent to which implementation capability predicted relative commitment. We explored whether relative commitment or implementation capability measures were associated with earlier initiation of DIAMOND improvements. All five implementation capability measures independently predicted practice leaders' relative commitment to improving depression care in the following year. These included the following: quality improvement culture and attitudes (p = 0.003), depression culture and attitudes (p commitment (p = 0.002) and prior depression quality improvement activities appeared to be associated with earlier participation in the DIAMOND initiative. The study supports the concept of organizational readiness to improve quality of care and the use of practice leader surveys to assess it. Practice leaders' relative commitment to depression care

Trend of Medical Tourism Publications: An Attempt to Explore the Involved Academic Disciplines and Interests.

Science.gov (United States)

Rokni, Ladan; Park, Sam-Hun

2018-02-01

Medical tourism suffers from the lack of a consensus regarding the involved categories. This study aimed to address this gap from the academic disciplines and publications perspective. Totally 1954 citations were identified through a formula of keyword search of SCOPUS. In order to classify the various subject areas, we followed the international standard classification of education (ISCED) developed by UNESCO. Moreover, the trends of publications were identified based on their popularity between 2000 and 2017. The category with the most interests on publication about medical tourism was 'health and welfare', followed by 'social science'. Even though various disciplines were involved in the medical tourism, it seems that a downward trend has been experienced since 2015. The identified key trends of medical tourism publications will benefit researchers exploring the categories of medical tourism or health travel. The results contribute to advance the state of knowledge from the academic perspective.

Dual peer mentoring program for undergraduate medical students: exploring the perceptions of mentors and mentees.

Science.gov (United States)

Abdolalizadeh, Parya; Pourhassan, Saeed; Gandomkar, Roghayeh; Heidari, Farrokh; Sohrabpour, Amir Ali

2017-01-01

Background: Despite the advantages of dual peer mentoring, there are a few reports of implementing and evaluating such programs for medical students. This study aimed at exploring the perceptions of mentors and mentees about the dual peer mentoring program for the first year undergraduate medical students of Tehran University of Medical Sciences. Methods: This qualitative study was conducted at the end of the first year of implementing the mentoring program. All mentees and mentors were invited to participate in focus group discussions. Data were analyzed using a qualitative content analysis. Results: All mentors ( n= 12 ) and a group of mentees ( n= 21 ) participated in focus group discussion sessions. We provided a variety of supports for the mentees including academic and psychosocial support and positive relationship; as a result, some developments occurred to the mentors We also explored participants' views on some unique aspects of the program such as student-authorized, dual mentoring, and role model sessions. Conclusion: Our participants found the mentoring program beneficial in various academic achievements and psychosocial supports for both the mentors and the mentees. Dual peer mentoring program can be an alternative to school administered programs.

How we created a peer-designed specialty-specific selective for medical student career exploration.

Science.gov (United States)

Keating, Elizabeth M; O'Donnell, Erin P; Starr, Stephanie R

2013-01-01

In recent years, medical students have recognized and advocated for opportunities to explore various specialties earlier in their medical education. A brief literature review, however, reveals little consensus on the best approach to introduce students to different fields during their preclinical years. We present one of the first reports of a student-led effort to design and implement a preclinical specialty-specific elective. At Mayo Medical School, for two consecutive years the student president of the Pediatric Interest Group has created a peer-designed weeklong group elective ("selective") experience consisting of workshops, faculty and resident panel discussions, and clinical shadowing experiences based on a student needs assessment. Each year, more than 25% of the first- and second-year medical student body participated. The majority of students who completed the selective agreed that this experience heightened their interests and expanded their knowledge about pediatrics. The pediatric group selective has provided students with important resources for their medical education and future careers. Students found the group selective beneficial to their learning experience and recommend continuing to offer it in the future.

Five different types of framing effects in medical situation: a preliminary exploration.

Science.gov (United States)

Peng, Jiaxi; Li, Hongzheng; Miao, Danmin; Feng, Xi; Xiao, Wei

2013-02-01

Considerable reports concerned the framing effect in medical situations. But quite few of them noticed to explore the differences among the various kinds of framing effects. In the present study, five different types of framing effects were examined and the effect sizes of them were compared. Medical decision making problems concerning medicine effect evaluation, patient's compliance, treatment and doctor options selection were established. All the problems were described in both positive and negative frames. 500 undergraduates as participants were randomly divided into ten groups. Participants from each group were asked to finish one decision making task. ALL THE FRAMES THAT WERE EXAMINED LEADED TO SIGNIFICANT FRAMING EFFECTS: When the Asia Disease Problem was described in a positive frame, the participants preferred the conservative frame than the risky one, while if in a negative frame, the preference reversed (P make more positive evaluations, compared with described as "of 100 patients taking this kind of medicine, 30 patients didn't become better" (P frame and the former one resulted in a better compliance (P framing effect was also tested to be significant (P framing effects were small to big in effect size. Medical decision making can be affected by frame descriptions. Attentions should be paid on the standardization of description in medical practice.

A qualitative study exploring issues related to medication management in residential aged care facilities.

Science.gov (United States)

Ahmad Nizaruddin, Mariani; Omar, Marhanis-Salihah; Mhd-Ali, Adliah; Makmor-Bakry, Mohd

2017-01-01

Globally, the population of older people is on the rise. As families are burdened with the high cost of care for aging members, demand is increasing for medical care and nursing homes. Thus, medication management is crucial to ensure that residents in a care center benefit and assist the management of the care center in reducing the burden of health care. This study is aimed to qualitatively explore issues related to medication management in residential aged care facilities (RACFs). A total of 11 stakeholders comprising health care providers, administrators, caretakers and residents were recruited from a list of registered government, nongovernmental organization and private RACFs in Malaysia from September 2016 to April 2017. An exploratory qualitative study adhering to Consolidated Criteria for Reporting Qualitative Studies was conducted. In-depth interview was conducted with consent of all participants, and the interviews were audio recorded for later verbatim transcription. Observational analysis was also conducted in a noninterfering manner. Three themes, namely medication use process, personnel handling medications and culture, emerged in this study. Medication use process highlighted an unclaimed liability for residents' medication by the RACFs, whereas personnel handling medications were found to lack sufficient training in medication management. Culture of the organization did affect the medication safety and quality improvement. The empowerment of the residents in their medication management was limited. There were unclear roles and responsibility of who manages the medication in the nongovernment-funded RACFs, although they were well structured in the private nursing homes. There are important issues related to medication management in RACFs which require a need to establish policy and guidelines.

Exploring factors affecting undergraduate medical students' study strategies in the clinical years: a qualitative study.

NARCIS (Netherlands)

Al Kadri, H.M.; Al-Moamary, M.S.; Elzubair, M.; Magzoub, M.E.; AlMutairi, A.; Roberts, C.; Vleuten, C.P.M. van der

2011-01-01

The aim of this study is to explore the effects of clinical supervision, and assessment characteristics on the study strategies used by undergraduate medical students during their clinical rotations. We conducted a qualitative phenomenological study at King Saud Bin Abdulaziz University for Health

Visual analytics in healthcare education: exploring novel ways to analyze and represent big data in undergraduate medical education

Directory of Open Access Journals (Sweden)

Christos Vaitsis

2014-11-01

Full Text Available Introduction. The big data present in the medical curriculum that informs undergraduate medical education is beyond human abilities to perceive and analyze. The medical curriculum is the main tool used by teachers and directors to plan, design, and deliver teaching and assessment activities and student evaluations in medical education in a continuous effort to improve it. Big data remains largely unexploited for medical education improvement purposes. The emerging research field of visual analytics has the advantage of combining data analysis and manipulation techniques, information and knowledge representation, and human cognitive strength to perceive and recognize visual patterns. Nevertheless, there is a lack of research on the use and benefits of visual analytics in medical education.Methods. The present study is based on analyzing the data in the medical curriculum of an undergraduate medical program as it concerns teaching activities, assessment methods and learning outcomes in order to explore visual analytics as a tool for finding ways of representing big data from undergraduate medical education for improvement purposes. Cytoscape software was employed to build networks of the identified aspects and visualize them.Results. After the analysis of the curriculum data, eleven aspects were identified. Further analysis and visualization of the identified aspects with Cytoscape resulted in building an abstract model of the examined data that presented three different approaches; (i learning outcomes and teaching methods, (ii examination and learning outcomes, and (iii teaching methods, learning outcomes, examination results, and gap analysis.Discussion. This study identified aspects of medical curriculum that play an important role in how medical education is conducted. The implementation of visual analytics revealed three novel ways of representing big data in the undergraduate medical education context. It appears to be a useful tool to

Visual analytics in healthcare education: exploring novel ways to analyze and represent big data in undergraduate medical education.

Science.gov (United States)

Vaitsis, Christos; Nilsson, Gunnar; Zary, Nabil

2014-01-01

Introduction. The big data present in the medical curriculum that informs undergraduate medical education is beyond human abilities to perceive and analyze. The medical curriculum is the main tool used by teachers and directors to plan, design, and deliver teaching and assessment activities and student evaluations in medical education in a continuous effort to improve it. Big data remains largely unexploited for medical education improvement purposes. The emerging research field of visual analytics has the advantage of combining data analysis and manipulation techniques, information and knowledge representation, and human cognitive strength to perceive and recognize visual patterns. Nevertheless, there is a lack of research on the use and benefits of visual analytics in medical education. Methods. The present study is based on analyzing the data in the medical curriculum of an undergraduate medical program as it concerns teaching activities, assessment methods and learning outcomes in order to explore visual analytics as a tool for finding ways of representing big data from undergraduate medical education for improvement purposes. Cytoscape software was employed to build networks of the identified aspects and visualize them. Results. After the analysis of the curriculum data, eleven aspects were identified. Further analysis and visualization of the identified aspects with Cytoscape resulted in building an abstract model of the examined data that presented three different approaches; (i) learning outcomes and teaching methods, (ii) examination and learning outcomes, and (iii) teaching methods, learning outcomes, examination results, and gap analysis. Discussion. This study identified aspects of medical curriculum that play an important role in how medical education is conducted. The implementation of visual analytics revealed three novel ways of representing big data in the undergraduate medical education context. It appears to be a useful tool to explore such data

May I see your ID, please? An explorative study of the professional identity of undergraduate medical education leaders.

Science.gov (United States)

Sundberg, Kristina; Josephson, Anna; Reeves, Scott; Nordquist, Jonas

2017-02-01

The mission of undergraduate medical education leaders is to strive towards the enhancement of quality of medical education and health care. The aim of this qualitative study is, with the help of critical perspectives, to contribute to the research area of undergraduate medical education leaders and their identity formation; how can the identity of undergraduate medical education leaders be defined and further explored from a power perspective? In this explorative study, 14 educational leaders at a medical programme in Scandinavia were interviewed through semi-structured interviews. The data was analysed through Moustakas' structured, phenomenological analysis approach and then pattern matched with Gee's power-based identity model. Educational leaders identify themselves more as mediators than leaders and do not feel to any larger extent that their professional identity is authorised by the university. These factors potentially create difficulties when trying to communicate with medical teachers, often also with a weaker sense of professional identity, about medical education. The perceptions of the professional identity of undergraduate medical education leaders provide us with important notions on the complexities on executing their important mission to develop medical education: their perceptions of ambiguity towards the process of trying to lead teachers toward educational development and a perceived lack of authorisation of their work from the university level. These are important flaws to observe and correct when improving the context in which undergraduate medical education leaders are trying to develop and improve undergraduate medical programmes. A practical outcome of the results of this study is the facilitation of design of faculty development programmes for educational leaders in undergraduate medial education.

Exploring the association between parental rearing styles and medical students' critical thinking disposition in China.

Science.gov (United States)

Huang, Lei; Wang, Zhaoxin; Yao, Yuhong; Shan, Chang; Wang, Haojie; Zhu, Mengyi; Lu, Yuan; Sun, Pengfei; Zhao, Xudong

2015-05-14

Critical thinking is an essential ability for medical students. However, the relationship between parental rearing styles and medical students' critical thinking disposition has rarely been considered. The aim of this study was to investigate whether parental rearing styles were significant predictors of critical thinking disposition among Chinese medical students. 1,075 medical students from the first year to the fifth year attending one of three medical schools in China were recruited via multistage stratified cluster sampling. The Chinese Critical Thinking Disposition Inventory(CTDI-CV) and The Egna Minnen av Barndoms Uppfostran (EMBU) questionnaire were applied to collect data and to conduct descriptive analysis. Stepwise multiple linear regression was used to analyze the data. The critical thinking disposition average mean score was 287.44 with 632 participants (58.79%) demonstrating positive critical thinking disposition. Stepwise multiple linear regression analysis revealed that the rearing styles of fathers, including "overprotection", "emotional warmth and understanding", "rejection" and "over-interference" were significant predictors of medical students' critical thinking disposition that explained 79.0% of the variance in critical thinking ability. Rearing styles of mothers including "emotional warmth and understanding", "punishing" and "rejection" were also found to be significant predictors, and explained 77.0% of the variance. Meaningful association has been evidenced between parental rearing styles and Chinese medical students' critical thinking disposition. Parental rearing styles should be considered as one of the many potential determinant factors that contribute to the cultivation of medical students' critical thinking capability. Positive parental rearing styles should be encouraged in the cultivation of children's critical thinking skills.

Governance capabilities for dealing wisely with wicked problems

NARCIS (Netherlands)

Termeer, C.J.A.M.; Dewulf, A.; Breeman, G.E.; Stiller, S.J.

2015-01-01

This article explores an integrative approach for dealing with wicked problems. Wicked problems not only require alternative action strategies but also alternative ways of observing and enabling. Four governance capabilities are essential: (a) reflexivity, or the capability to deal with multiple

A qualitative study exploring issues related to medication management in residential aged care facilities

Directory of Open Access Journals (Sweden)

Ahmad Nizaruddin M

2017-11-01

Full Text Available Mariani Ahmad Nizaruddin, Marhanis-Salihah Omar, Adliah Mhd-Ali, Mohd Makmor-Bakry Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia Background: Globally, the population of older people is on the rise. As families are burdened with the high cost of care for aging members, demand is increasing for medical care and nursing homes. Thus, medication management is crucial to ensure that residents in a care center benefit and assist the management of the care center in reducing the burden of health care. This study is aimed to qualitatively explore issues related to medication management in residential aged care facilities (RACFs.Participants and methods: A total of 11 stakeholders comprising health care providers, administrators, caretakers and residents were recruited from a list of registered government, nongovernmental organization and private RACFs in Malaysia from September 2016 to April 2017. An exploratory qualitative study adhering to Consolidated Criteria for Reporting Qualitative Studies was conducted. In-depth interview was conducted with consent of all participants, and the interviews were audio recorded for later verbatim transcription. Observational analysis was also conducted in a noninterfering manner.Results and discussion: Three themes, namely medication use process, personnel handling medications and culture, emerged in this study. Medication use process highlighted an unclaimed liability for residents’ medication by the RACFs, whereas personnel handling medications were found to lack sufficient training in medication management. Culture of the organization did affect the medication safety and quality improvement. The empowerment of the residents in their medication management was limited. There were unclear roles and responsibility of who manages the medication in the nongovernment-funded RACFs, although they were well structured in the private nursing homes.Conclusion: There are important issues

Health aspects of Arctic exploration – Alaska's medical history based on the research files of Dr. Robert Fortuine

Directory of Open Access Journals (Sweden)

Kathleen Murray

2013-08-01

Full Text Available Background . Robert Fortuine provided basic medical care to Alaska Native people, chronicled the Health Aspects of Arctic Exploration and through a number of influential publications, was the first to thoroughly document and analyse Alaska's Medical History. This overview of his published work will provide the reader with a detailed overview, so that they can begin to explore Dr. Fortuine's many published works in more detail. Objective . This review will explore Alaska's Medical History and the Health Aspects of Arctic Exploration through the research files and the 10 most significant publications of Dr. Robert Fortuine. Design . Review of Dr. Fortuine's major works and the master bibliography has over 3,000 references and 81 subjects. The master bibliography is a merger of 55 separate bibliographies, which provides a wealth of bibliographic information. This paper will describe his 10 most significant publications, 2 of which began as a journal issue. Results . Dr. Fortuine was a prolific writer throughout his career, publishing 134 articles and books. He wrote papers and books on Alaska's medical history, tuberculosis and health care delivery from Russian–America through the Public Health Service efforts in the territory and then the State of Alaska. The master bibliography has over 3,000 references and 81 subjects. This list has a significant number of entries for tuberculosis with almost one-third of the entries including this heading. Others dwell on the history of “pre-contact” health, the history of Alaska Native health care, the history of the Alaska Department of Health, especially the tuberculosis programme, the role of the US Public Health Service and traditional medicine. He completely reviewed every Governors’ and the US Surgeon General's reports in regard to Alaska content. This paper describes his 10 most significant publications. Conclusions . Robert Fortuine's published works offer a wealth of information and insight

Capabilities for Intercultural Dialogue

Science.gov (United States)

Crosbie, Veronica

2014-01-01

The capabilities approach offers a valuable analytical lens for exploring the challenge and complexity of intercultural dialogue in contemporary settings. The central tenets of the approach, developed by Amartya Sen and Martha Nussbaum, involve a set of humanistic goals including the recognition that development is a process whereby people's…

Weaving together peer assessment, audios and medical vignettes in teaching medical terms

Science.gov (United States)

Khan, Lateef M.

2015-01-01

Objectives The current study aims at exploring the possibility of aligning peer assessment, audiovisuals, and medical case-report extracts (vignettes) in medical terminology teaching. In addition, the study wishes to highlight the effectiveness of audio materials and medical history vignettes in preventing medical students' comprehension, listening, writing, and pronunciation errors. The study also aims at reflecting the medical students' attitudes towards the teaching and learning process. Methods The study involved 161 medical students who received an intensive medical terminology course through audio and medical history extracts. Peer assessment and formative assessment platforms were applied through fake quizzes in a pre- and post-test manner. An 18-item survey was distributed amongst students to investigate their attitudes and feedback towards the teaching and learning process. Quantitative and qualitative data were analysed using the SPSS software. Results The students did better in the posttests than on the pretests for both the quizzes of audios and medical vignettes showing a t-test of -12.09 and -13.60 respectively. Moreover, out of the 133 students, 120 students (90.22%) responded to the survey questions. The students gave positive attitudes towards the application of audios and vignettes in the teaching and learning of medical terminology and towards the learning process. Conclusions The current study revealed that the teaching and learning of medical terminology have more room for the application of advanced technologies, effective assessment platforms, and active learning strategies in higher education. It also highlights that students are capable of carrying more responsibilities of assessment, feedback, and e-learning. PMID:26637986

Developing Soft Power Using Afloat Medical Capability

Science.gov (United States)

2009-03-02

engagement with the nations in the Asia -Pacific region contributed to considerable progress across a broad range of security issues. Southeast Asia remains...Forces and the U.S. military has been positive and valuable in the War on Terror and humanitarian assistance.20 The poor economies, overpopulation , weak...Public Health Services combined to conduct a medical and dental civil-assistance program (MEDCAP/DENCAP) visit throughout Southeast Asia and Oceania.42

Exploring the notion of a 'capability for uncertainty' and the implications for leader development

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Kathy Bennett

2016-10-01

Full Text Available Orientation: With uncertainty increasingly defining organisational contexts, executive leaders need to develop their ‘capability for uncertainty’ – the ability to engage with uncertainty in their organisational context and to lead others, while simultaneously managing their own experience of uncertainty. However, what constitutes such a holistic ‘capability for uncertainty’ is not clear. Research purpose: The purpose was to gain an understanding of what constitutes a capability for uncertainty. Motivation for the study: Gaining an understanding of what components constitute leaders’ capability for uncertainty would provide a basis for determining what interventions would be relevant for developing leaders towards achieving such a capability. Research approach, design and method: An interpretive qualitative approach was adopted, using interpretative phenomenological analysis to gain an understanding of what capability executive leaders developed through their lived experience of uncertainty. Two purposive samples of six executive leaders from two different South African companies (a private company and a state-owned company, which had both been experiencing long-term organisational uncertainty prior to and up to the time of the study, were used. Data were collected through semi-structured interviews. Main findings: The executives all developed their capability for uncertainty through lived experiences of uncertainty, to a greater or lesser extent. Five components were identified as constituting a holistic capability for uncertainty, as follows: a sense of positive identity, an acceptance of uncertainty, effective sense-making, learning agility and relevant leadership practices during organisational uncertainty. Practical/managerial implications: Organisations need to target and design leader development interventions to specifically develop these components of a holistic capability for uncertainty in executives and leaders, enabling

The Exploration of Design Driven Innovation as a Dynamic Capability

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Philips Kembaren

2012-01-01

Full Text Available Innovation enables companies to attain consistent organic growth that brings benefits to stakeholders. Designthinking approach in innovation has been emergent to be an alternative to technological development path inorder to generate competitive and successful product or service in the market place. Design driven innovationcombines functional and semantic dimensions of products or services in the marketplace. Previous researchhas recently revealed practices of design driven innovation in various industries. However, little is known tothe extent that companies in Indonesia practicing design driven innovation. A theoretical framework withperspective from dynamic capability theoretical lens and guided by Dubin’s theory building methodology isproposed to explain the constructs and role of design in the process of innovation. The research is expected tocontribute a new construct to the existing framework, namely construct that related to how we could assessthe value of the design-driven innovation output, perceived by the costumers.Keywords: design driven innovation, dynamic capabilities, theory building

Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions: ExMC Pharmacy Research Plan

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Antonsen, Erik

2016-01-01

The Exploration Medical Capabilities (ExMC) Element of NASA's Human Research Program is charged with identifying medical capabilities that can address the challenges of prevention, diagnosis, and treatment of disease and injuries that could occur during exploration missions beyond Earth's orbit. Faced with the obstacle of access to in-flight medical care, and limitations of vehicle space, time, and communications; it is necessary to prioritize what medical consumables are manifested for the flight, and which medical conditions are addressed. Studies of astronaut health establish the incidence of common and high risk medical conditions that require medical intervention during long-duration exploration missions. In 2000, the Institute of Medicine (IOM) convened a committee of experts, Committee on Creating a Vision for Space Medicine during Travel beyond Earth Orbit, to examine the issues surrounding astronaut health and safety for long duration space missions. Two themes run throughout the committee's final report: (1) that not enough is known about the risks to human health during long-duration missions beyond Earth's orbit or about what can effectively mitigate those risks to enable humans to travel and work safely in the environment of deep space and (2) that everything reasonable should be done to gain the necessary information before humans are sent on missions of space exploration (IOM, 2001). Although several spaceflight focused pharmaceutical research studies have been conducted, few have provided sufficient data regarding medication usage or potency changes during spaceflight. The Du pharmaceutical stability study assessed medications flown on space shuttles to and from the International Space Station (ISS) from 2006 until 2008; of which some medications were still viable beyond their expiration dates (Du et al, 2011). However, as with many spaceflight studies, the small 'n' associated with this study limits the ability to draw strong conclusions from it

Challenges in Clinical Management of Radiation-Induced Illnesses in Exploration Spaceflight

Science.gov (United States)

Blue, Rebecca; Chancellor, Jeffery; Suresh, Rahul; Carnell, Lisa; Reyes, David; Nowadly, Craig; Antonsen, Erik

2018-01-01

Historical solar particle events (SPEs) provide context for some understanding of acute radiation exposure risk to astronauts traveling outside of low Earth orbit. Modeling of potential doses delivered to exploration crewmembers anticipates limited radiation-induced health impacts, including prodromal symptoms of nausea, emesis, and fatigue, but suggests that more severe clinical manifestations are unlikely. Recent large animal-model research in space-analogs closely mimicking SPEs has identified coagulopathic events independent of the hematopoietic sequelae of higher radiation doses, similar in manifestation to disseminated intravascular coagulation (DIC). We explored the challenges of clinical management of radiation-related clinical manifestations, using currently accepted modeling techniques and anticipated physiological sequelae, to identify medical capabilities needed to successfully manage SPE-induced radiation illnesses during exploration spaceflight.

Exploring the resource and capabilities of food related enterprises in ...

African Journals Online (AJOL)

Specifically, the two case studies illustrate the capabilities of business owners to identify assets at their establishments and the municipality level and reconfigure them into objects aimed at providing experiences for visitors seeking out for rural idyll. The implications of this study on policy and practice on entrepreneurship ...

Leadership and followership in the healthcare workplace: exploring medical trainees’ experiences through narrative inquiry

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Gordon, Lisi J; Rees, Charlotte E; Ker, Jean S; Cleland, Jennifer

2015-01-01

Objectives To explore medical trainees’ experiences of leadership and followership in the interprofessional healthcare workplace. Design A qualitative approach using narrative interviewing techniques in 11 group and 19 individual interviews with UK medical trainees. Setting Multisite study across four UK health boards. Participants Through maximum variation sampling, 65 medical trainees were recruited from a range of specialties and at various stages of training. Participants shared stories about their experiences of leadership and followership in the healthcare workplace. Methods Data were analysed using thematic and narrative analysis. Results We identified 171 personal incident narratives about leadership and followership. Participants most often narrated experiences from the position of follower. Their narratives illustrated many factors that facilitate or inhibit developing leadership identities; that traditional medical and interprofessional hierarchies persist within the healthcare workplace; and that wider healthcare systems can act as barriers to distributed leadership practices. Conclusions This paper provides new understandings of the multiple ways in which leadership and followership is experienced in the healthcare workplace and sets out recommendations for future leadership educational practices and research. PMID:26628525

Concept of Operations Evaluation for Mitigating Space Flight-Relevant Medical Issues in a Planetary Habitat

Science.gov (United States)

Barsten, Kristina; Hurst, Victor, IV; Scheuring, Richard; Baumann, David K.; Johnson-Throop, Kathy

2010-01-01

Introduction: Analogue environments assist the NASA Human Research Program (HRP) in developing capabilities to mitigate high risk issues to crew health and performance for space exploration. The Habitat Demonstration Unit (HDU) is an analogue habitat used to assess space-related products for planetary missions. The Exploration Medical Capability (ExMC) element at the NASA Johnson Space Center (JSC) was tasked with developing planetary-relevant medical scenarios to evaluate the concept of operations for mitigating medical issues in such an environment. Methods: Two medical scenarios were conducted within the simulated planetary habitat with the crew executing two space flight-relevant procedures: Eye Examination with a corneal injury and Skin Laceration. Remote guidance for the crew was provided by a flight surgeon (FS) stationed at a console outside of the habitat. Audio and video data were collected to capture the communication between the crew and the FS, as well as the movements of the crew executing the procedures. Questionnaire data regarding procedure content and remote guidance performance also were collected from the crew immediately after the sessions. Results: Preliminary review of the audio, video, and questionnaire data from the two scenarios conducted within the HDU indicate that remote guidance techniques from an FS on console can help crew members within a planetary habitat mitigate planetary-relevant medical issues. The content and format of the procedures were considered concise and intuitive, respectively. Discussion: Overall, the preliminary data from the evaluation suggest that use of remote guidance techniques by a FS can help HDU crew execute space exploration-relevant medical procedures within a habitat relevant to planetary missions, however further evaluations will be needed to implement this strategy into the complete concept of operations for conducting general space medicine within similar environments

Geospatial Information System Capability Maturity Models

Science.gov (United States)

2017-06-01

To explore how State departments of transportation (DOTs) evaluate geospatial tool applications and services within their own agencies, particularly their experiences using capability maturity models (CMMs) such as the Urban and Regional Information ...

Intelligent distributed medical image management

Science.gov (United States)

Garcia, Hong-Mei C.; Yun, David Y.

1995-05-01

The rapid advancements in high performance global communication have accelerated cooperative image-based medical services to a new frontier. Traditional image-based medical services such as radiology and diagnostic consultation can now fully utilize multimedia technologies in order to provide novel services, including remote cooperative medical triage, distributed virtual simulation of operations, as well as cross-country collaborative medical research and training. Fast (efficient) and easy (flexible) retrieval of relevant images remains a critical requirement for the provision of remote medical services. This paper describes the database system requirements, identifies technological building blocks for meeting the requirements, and presents a system architecture for our target image database system, MISSION-DBS, which has been designed to fulfill the goals of Project MISSION (medical imaging support via satellite integrated optical network) -- an experimental high performance gigabit satellite communication network with access to remote supercomputing power, medical image databases, and 3D visualization capabilities in addition to medical expertise anywhere and anytime around the country. The MISSION-DBS design employs a synergistic fusion of techniques in distributed databases (DDB) and artificial intelligence (AI) for storing, migrating, accessing, and exploring images. The efficient storage and retrieval of voluminous image information is achieved by integrating DDB modeling and AI techniques for image processing while the flexible retrieval mechanisms are accomplished by combining attribute- based and content-based retrievals.

Judgmental Forecasting of Operational Capabilities

DEFF Research Database (Denmark)

Hallin, Carina Antonia; Tveterås, Sigbjørn; Andersen, Torben Juul

This paper explores a new judgmental forecasting indicator, the Employee Sensed Operational Capabilities (ESOC). The purpose of the ESOC is to establish a practical prediction tool that can provide early signals about changes in financial performance by gauging frontline employees’ sensing...... of changes in the firm’s operational capabilities. We present the first stage of the development of ESOC by applying a formative measurement approach to test the index in relation to financial performance and against an organizational commitment scale. We use distributed lag models to test whether the ESOC...

Early assessment of medical devices in development for company decision making : An exploration of best practices

NARCIS (Netherlands)

Markiewicz, Katarzyna; Van Til, Janine; IJzerman, Maarten

2017-01-01

To improve successful development and clinical use of medical technologies, it is suggested that manufacturers should start collecting evidence on devices effectiveness and eficiency early in their development. The aim of this study was to explore whether and how Dutch manufacturers perform an early

Exploring Integration in Action: Competencies as Building Blocks of Expertise.

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Mylopoulos, Maria; Borschel, Debaroti Tina; O'Brien, Tara; Martimianakis, Sofia; Woods, Nicole N

2017-12-01

Competency frameworks such as the CanMEDS roles and the ACGME core competencies may lead to the implicit assumption that physicians can learn and practice individual competencies in isolation. In contrast, models of adaptive expertise suggest that the integration of competencies reflects the capabilities of an expert physician. Thus, educational programming aimed at teaching discrete roles or competencies might overlook expert physician capabilities that are central to patient care. To develop expertise, learning opportunities must reflect expert capabilities. To better understand the relationship between competency-based medical education and expert development, the authors sought to explore how integrated competencies are enacted during patient care by postgraduate medical trainees. Using a cognitive ethnographic approach, in 2014-2015 the authors conducted observations and-to refine and elaborate these observations-ad hoc informal interviews with 13 postgraduate trainee participants. Data collection resulted in 92 hours of observation, 26 patient case portraits, and a total of 220 pages of field notes for analysis. Through analysis, the authors identified and examined moments when postgraduate trainees appeared to be simultaneously enacting multiple competencies. The authors identified two key expert capabilities in moments of integrated competence: finding complexity and being patient-centered. They described two mechanisms for these forms of integration: valuing the patient's narrative of their illness, and integrated understanding. Understanding integrated competencies as the building blocks of expert capabilities, along with recognizing the importance of mechanisms that support integration, offers an opportunity to use existing competency-based frameworks to understand and teach adaptive expertise.

An Exploration of the Benefits of an Animallike Robot Companion with More Advanced Touch Interaction Capabilities for Dementia Care

Directory of Open Access Journals (Sweden)

Merel M. Jung

2017-06-01

Full Text Available Animallike robot companions such as robotic seal Paro are increasingly used in dementia care due to the positive effects that interaction with these robots can have on the well-being of these patients. Touch is one of the most important interaction modalities for patients with dementia and can be a natural way to interact with animallike robots. To advance the development of animallike robots, we explored in what ways people with dementia could benefit from interaction with an animallike robot with more advanced touch recognition capabilities and which touch gestures would be important in their interaction with Paro. In addition, we explored which other target groups might benefit from interaction with animallike robots with more advanced interaction capabilities. In this study, we administered a questionnaire and conducted interviews with two groups of health-care providers who all worked in a geriatric psychiatry department. One group used Paro in their work (i.e., the expert group; n = 5 while the other group had no experience with the use of animallike robot (i.e., the layman group; n = 4. The results showed that health-care providers perceived Paro as an effective intervention to improve the well-being of people with dementia. Examples of usages for Paro that were mentioned were providing distraction, interrupting problematic behaviors, and stimulating communication. Furthermore, the care providers indicated that people with dementia (would use mostly positive forms of touch and speech to interact with Paro. Paro’s auditory responses were criticized because they can overstimulate the patients. In addition, the care providers argued that social interactions with Paro are currently limited and therefore the robot does not meet the needs of a broader audience such as healthy elderly people who still live in their own homes. The development of robot pets with more advanced social capabilities such as touch and speech recognition might

Human Health and Performance Considerations for Exploration of Near-Earth Asteroids

Science.gov (United States)

Kundrot, Craig; Steinberg, Susan; Charles, John

2010-01-01

This presentation will describe the human health and performance issues that are anticipated for the human exploration of near-Earth asteroids (NEA). Humans are considered a system in the design of any such deep-space exploration mission, and exploration of NEA presents unique challenges for the human system. Key factors that define the mission are those that are strongly affected by distance and duration. The most critical of these is deep-space radiation exposure without even the temporary shielding of a nearby large planetary body. The current space radiation permissible exposure limits (PEL) restrict mission duration to 3-10 months depending on age and gender of crewmembers and stage of the solar cycle. Factors that affect mission architecture include medical capability; countermeasures for bone, muscle, and cardiovascular atrophy during continuous weightlessness; restricted food supplies; and limited habitable volume. The design of a habitat that can maintain the physical and psychological health of the crew and support mission operations with limited intervention from Earth will require an integrated research and development effort by NASA s Human Research Program, engineering, and human factors groups. Limited abort and return options for an NEA mission are anticipated to have important effects on crew psychology as well as influence medical supplies and training requirements of the crew. Other important factors are those related to isolation, confinement, communication delays, autonomous operations, task design, small crew size, and even the unchanging view outside the windows for most of the mission. Geological properties of the NEA will influence design of sample handling and containment, and extravehicular activity capabilities including suit ports and tools. A robotic precursor mission that collects basic information on NEA surface properties would reduce uncertainty about these aspects of the mission as well as aid in design of mission architecture and

Deployment of vendor capabilities and competences throughout the outsourcing process

DEFF Research Database (Denmark)

Perunovic, Zoran; Christoffersen, Mads; Mefford, Robert N.

2012-01-01

Purpose - A vendor's capabilities are recognized as one of the most important factors for success in outsourcing. However, there is a lack of understanding of how vendors manage their capabilities throughout the outsourcing process. With an aim to contribute to filling this existing gap......, the purpose of this paper is to explore how vendors deploy their capabilities in order to win, run and renew the outsourcing contracts. Design/methodology/approach - The research question has been derived by integrating a resource-based view theory with a model of a vendor's process in outsourcing. A multiple......-case study of three contract electronic manufacturers has been employed to explore the research question. Findings - The results show that for achieving their outsourcing objectives, vendors use different capability mixes: the winning, the running, and the renewing. These mixes are created through...

How Should Air Force Expeditionary Medical Capabilities Be Expressed

Science.gov (United States)

2009-01-01

Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Sci- ence, Vol. 4, 2006, pp. 135–146; Sarah A. Lister, Hurricane Katrina: The Public...setting this might mean releasing the patient to a nursing home. In a domestic civilian disaster setting, it may mean releasing the patient to some...described below. The Mobile Aeromedical Staging Facility (MASF) is a 15-person, communications-capable UTC that provides supportive/resuscita- tive nursing

Exploring reflective 'critical incident' documentation of professionalism lapses in a medical undergraduate setting

Directory of Open Access Journals (Sweden)

McLachlan John C

2009-07-01

Full Text Available Abstract Background Measuring professionalism in undergraduate medical students is a difficult process, and no one method has currently emerged as the definitive means of assessment in this field. Student skills in reflection have been shown to be highly important in the development of professional behaviours. By studying student reflections on lapses in professional judgement, recorded as 'critical incidents', it is possible to explore themes which are significant for the development of professional behaviour in an undergraduate setting. Methods We examined critical incident reporting combined with optional written student reflection as a method for exploring professionalism in undergraduate medical students. 228 students split between Year 1 and 2 of one academic year of undergraduate medicine were studied retrospectively and a grounded theory approach to analysis was employed. Results This year generated 16 critical incident reports and corresponding student reflections, all of which were considered. In addition to identifying the nature of the critical incidents, 3 principal themes emerged. These were the impact and consequences of the report having been made, student reactions to the events (both positive and negative, and student responses regarding future actions. Conclusion This study indicates that unprofessional behaviour can be identified and challenged by both the faculty and the students involved, and suggests that positive behavioural changes might be made with the aim of preventing future occurrences. We provide a low cost approach of measuring and recording professional behaviour.

Capabilities of a FOXSI Small Explorer

Science.gov (United States)

Inglis, A. R.; Christe, S.; Glesener, L.; Krucker, S.; Dennis, B. R.; Shih, A.; Wilson-Hodge, C.; Gubarev, M.; Hudson, H. S.; Kontar, E.; Buitrago Casas, J. C.; Drake, J. F.; Caspi, A.; Holman, G.; Allred, J. C.; Ryan, D.; Alaoui, M.; White, S. M.; Saint-Hilaire, P.; Klimchuk, J. A.; Hannah, I. G.; Antiochos, S. K.; Grefenstette, B.; Ramsey, B.; Jeffrey, N. L. S.; Reep, J. W.; Schwartz, R. A.; Ireland, J.

2015-12-01

We present the FOXSI (Focusing Optics X-ray Solar Imager) small explorer (SMEX) concept, a mission dedicated to studying particle acceleration and energy release on the Sun. FOXSI is designed as a 3-axis stabilized spacecraft in low-Earth orbit making use of state-of-the-art grazing incidence focusing optics, allowing for direct imaging of solar X-rays. The current design being studied features three telescope modules deployed in a low-inclination low-earth orbit (LEO). With a 15 meter focal length enabled by a deployable boom, FOXSI will observe the Sun in the 3-50 keV energe range. The FOXSI imaging concept has already been tested on two sounding rocket flights, in 2012 and 2014 and on the HEROES balloon payload flight in 2013. FOXSI will image the Sun with an angular resolution of 5'', a spectral resolution of 0.5 keV, and sub-second temporal resolution using CdTe detectors. In this presentation we investigate the science objectives and targets which can be accessed from this mission. Because of the defining characteristic of FOXSI is true imaging spectroscopy with high dynamic range and sensitivity, a brand-new perspective on energy release on the Sun is possible. Some of the science targets discussed here include; flare particle acceleration processes, electron beams, return currents, sources of solar energetic particles (SEPs), as well as understanding X-ray emission from active region structures and the quiescent corona.

Work system innovation: Designing improvement methods for generative capability

DEFF Research Database (Denmark)

Hansen, David; Møller, Niels

2013-01-01

This paper explores how a work system’s capability for improvement is influenced by its improvement methods. Based on explorative case study at a Lean manufacturing facility, the methods problem solving and Appreciative Inquiry were compared through in-depth qualitative studies over a 12-month...

Exploring example models of cross-sector, sessional employment of pharmacists to improve medication management and pharmacy support in rural hospitals.

Science.gov (United States)

Tan, Amy Cw; Emmerton, Lynne M; Hattingh, Laetitia; La Caze, Adam

2015-01-01

Many rural hospitals in Australia are not large enough to sustain employment of a full-time pharmacist, or are unable to recruit or retain a full-time pharmacist. The absence of a pharmacist may result in hospital nurses undertaking medication-related roles outside their scope of practice. A potential solution to address rural hospitals' medication management needs is contracted part-time ('sessional') employment of a local pharmacist external to the hospital ('cross-sector'). The aim of this study was to explore the roles and experiences of pharmacists in their provision of sessional services to rural hospitals with no on-site pharmacist and explore how these roles could potentially address shortfalls in medication management in rural hospitals. A qualitative study was conducted to explore models with pharmacists who had provided sessional services to a rural hospital. A semi-structured interview guide was informed by a literature review, preliminary research and stakeholder consultation. Participants were recruited via advertisement and personal contacts. Consenting pharmacists were interviewed between August 2012 and January 2013 via telephone or Skype for 40-55 minutes. Thirteen pharmacists with previous or ongoing hospital sessional contracts in rural communities across Australia and New Zealand participated. Most commonly, the pharmacists provided weekly services to rural hospitals. All believed the sessional model was a practical solution to increase hospital access to pharmacist-mediated support and to address medication management gaps. Roles perceived to promote quality use of medicines were inpatient consultation services, medicines information/education to hospital staff, assistance with accreditation matters and system reviews, and input into pharmaceutical distribution activities. This study is the first to explore the concept of sessional rural hospital employment undertaken by pharmacists in Australia and New Zealand. Insights from participants

Associations Between Polypharmacy and Cognitive and Physical Capability: A British Birth Cohort Study.

Science.gov (United States)

Rawle, Mark James; Cooper, Rachel; Kuh, Diana; Richards, Marcus

2018-03-24

To investigate longitudinal associations between polypharmacy and cognitive and physical capability and to determine whether these associations differ with cumulative exposure to polypharmacy. Prospective birth cohort study. England, Scotland, and Wales. An eligible sample of men and women from the Medical Research Council National Survey of Health and Development with medication data at age 69 (N=2,122, 79%). Cognitive capability was assessed using a word learning test, visual search speed task, and the Addenbrooke's Cognitive Examination, Third Edition (ACE-III). Physical capability was measured using chair rise speed, standing balance time, walking speed, and grip strength. Polypharmacy (5-8 prescribed medications) was present in 18.2% of participants at age 69 and excessive polypharmacy (≥9 prescribed medications) in 4.7%. Both were associated with poorer cognitive and physical capability in models adjusted for sex, education, and disease burden. Stronger associations were found for excessive polypharmacy (e.g., difference in mean ACE-III scores comparing polypharmacy=-2.0, 95% CI=-2.8 to -1.1 and excessive polypharmacy=-2.9, 95% CI=-4.4 to -1.4 with no polypharmacy). Participants with polypharmacy at age 60 to 64 and at age 69 showed stronger Negative associations with cognitive and physical capability were stronger still in participants with polypharmacy at both age 60 to 64 and at age 69 (e.g. difference in mean chair rise speed, comparing polypharmacy with no polypharmacy at both ages=-3.9, 95% CI=-5.2 to -2.6 and at age 60-64 only=-2.5, 95% CI=-4.1 to -0.9). Polypharmacy at age 60 to 64 and age 69 was associated with poorer physical and cognitive capability, even after adjusting for disease burden. Stronger negative associations were seen in participants with longstanding polypharmacy, suggesting a cumulative, dose-dependent relationship (where dose is the number of prescribed medications). Future research aiming to improve cognitive and physical

What is the role of community capabilities for maternal health? An exploration of community capabilities as determinants to institutional deliveries in Bangladesh, India, and Uganda

Directory of Open Access Journals (Sweden)

Ligia Paina

2016-11-01

Full Text Available Abstract Background While community capabilities are recognized as important factors in developing resilient health systems and communities, appropriate metrics for these have not yet been developed. Furthermore, the role of community capabilities on access to maternal health services has been underexplored. In this paper, we summarize the development of a community capability score based on the Future Health System (FHS project’s experience in Bangladesh, India, and Uganda, and, examine the role of community capabilities as determinants of institutional delivery in these three contexts. Methods We developed a community capability score using a pooled dataset containing cross-sectional household survey data from Bangladesh, India, and Uganda. Our main outcome of interest was whether the woman delivered in an institution. Our predictor variables included the community capability score, as well as a series of previously identified determinants of maternal health. We calculate both population-averaged effects (using GEE logistic regression, as well as sub-national level effects (using a mixed effects model. Results Our final sample for analysis included 2775 women, of which 1238 were from Bangladesh, 1199 from India, and 338 from Uganda. We found that individual-level determinants of institutional deliveries, such as maternal education, parity, and ante-natal care access were significant in our analysis and had a strong impact on a woman’s odds of delivering in an institution. We also found that, in addition to individual-level determinants, greater community capability was significantly associated with higher odds of institutional delivery. For every additional capability, the odds of institutional delivery would increase by up to almost 6 %. Conclusion Individual-level characteristics are strong determinants of whether a woman delivered in an institution. However, we found that community capability also plays an important role, and should be

Putting Role 1 first: the Role 1 capability review.

Science.gov (United States)

Hodgetts, T J; Findlay, S

2012-09-01

To quantify the risk for delivering care at Role 1 in the Land Environment (point of wounding to hospital care) on current operations and set the conditions for systematic change to enhance future capability. UK, US and Danish Army Role 1 Subject Matter Experts (SMEs) (1) Questionnaire study ofUK SMEs to determine capability gaps; (2) Questionnaire study of US and Danish SMEs to benchmark UK capability; (3) Semi-structured interviews of UK SMEs; (4) In-theatre evaluation of deployed Role 1. Thirty two SMEs completed the questionnaire (68% response rate), comprising 25 medical officers (20 in clinical appointments; five in command and staff appointments), six nurses and one medical support officer. Results of the entire review were collated as a cross-Defence Lines of Development analysis, separating the specific experience of 1 Medical Regiment's Hybrid Foundation Training (HFT), Mission Specific Training (MST) and deployment cycle from the analysis gained from questionnaire studies, SME consultation and documentary evidence. The review generated 77 recommendations and 38 sub-recommendations. The top six messages of the review were (1) To balance the expressed desire to increase the ratio of trained Team Medics with the reality of generating credible instructors with clinical experience; (2) To recognise that inadequate experience for Combat Medical Technicians in Primary Healthcare in the Firm Base undermines their operational preparedness; (3) To recognise that Current Regimental Aid Post (RAP) at contingency without power lacks the rudimentary infrastructure of a modern Medical Treatment Facility; (4) To recognise that inappropriate deployment of personnel with chronic disease or acutely limiting conditions is a consistent trend for 20 years that highlights continuing system weaknesses in applying protective medical grading; (5) To accept that General Practitioner manning requires re-evaluating as an Operational Pinch Point, reviewing all options to maintain

An exploration of the dynamics and influences upon second medical opinion consultations in cancer care.

Science.gov (United States)

Philip, Jennifer; Gold, Michelle; Schwarz, Max; Komesaroff, Paul

2011-03-01

The aim of this study was to explore the dynamics within second medical opinion consultations in patients with cancer. Semi-structured interviews were held with four oncologists and were subjected to a thematic analysis to define the broad issues. These formed the basis of a survey distributed to Australian medical oncologists. Overall 65 surveys were returned representing an overall response rate of 30% (10% and 63% electronic and hardcopy response rates, respectively). The dynamics in giving second medical opinions are influenced by the collegiate relationships of the doctors. Nearly two-thirds of oncologists believed that the first doctors' treatment and recommendations influenced the outcome of the second opinion, more than one-third believed the outcome was influenced by the relationship between the two doctors, and 41% believed the public nature of a second opinion was influential. In each case, these figures were more than double their assessments of patients' beliefs of these influences. Care was taken not to criticise the primary doctor. Second medical opinions provide an opportunity for oncologists to review medical care and engage in enhanced communication with patients who have additional needs. These consultations do not, however, occur in a vacuum but are influenced by the need to attend to relationships between the patient and their primary doctor and between the doctors themselves. The second medical opinion is embedded within a network of relationships and within the illness journey. © 2010 Blackwell Publishing Asia Pty Ltd.

The Interface of IT Capabilities and Disruptive Innovations

DEFF Research Database (Denmark)

Baiyere, Abayomi

2017-01-01

The occurrence of disruptive innovations tends to challenge the fabric, structure and capability that define firms facing their threat. Prior research indicates that the capacity of a firm to restructure and reconfigure its resources to face/leverage such turbulent situations is dependent on how...... well it can orchestrate its capabilities. Although IT capability has been identified as one of the essential capability of today’s organisations, managers as well as researchers are yet to uncover the dynamics through which an organisation’s IT capability can be leveraged in disruptive innovation...... situations. This paper contributes to our understanding in this direction by conceptually exploring the different roles of an organisation's IT capabilitiy in disruptive innovation scenarios. The paper provides a synthesis of the current state of knowledge about both concepts and extends this to highlight...

Business and IT Capabilities for Cloud Platform Success

DEFF Research Database (Denmark)

Hahn, Christopher; Huntgeburth, Jan; Winkler, Till J.

2016-01-01

The growing proliferation of cloud platform ecosystems demands a deeper understanding of the capabilities that help existing and emerging platform providers to be successful by creating and appropriating value. This multiple case study of four cloud platform providers (three large, one SME......) instantiates Rai and Tang’s (2014) framework of dyadic IT and network IT capabilities for a cloud platform context and extends it by exploring previously undertheorized cloud platform business capabilities. We further build on this extended framework by employing a configurational perspective to elucidate...... the complementary role of the three proposed business capabilities (incentives and rules, ecosystem marketing and sales, partner development and support) for relevant value creation and appropriation mechanisms. In addition to providing a capability framework catered to the cloud platform context, our findings...

On the Capability of Smartphones to Perform as Communication Gateways in Medical Wireless Personal Area Networks

Directory of Open Access Journals (Sweden)

María José Morón

2014-01-01

Full Text Available This paper evaluates and characterizes the technical performance of medicalwireless personal area networks (WPANs that are based on smartphones. For this purpose,a prototype of a health telemonitoring system is presented. The prototype incorporates acommercial Android smartphone, which acts as a relay point, or “gateway”, between a setof wireless medical sensors and a data server. Additionally, the paper investigates if theconventional capabilities of current commercial smartphones can be affected by their useas gateways or “Holters” in health monitoring applications. Specifically, the profiling hasfocused on the CPU and power consumption of the mobile devices. These metrics havebeen measured under several test conditions modifying the smartphone model, the type ofsensors connected to the WPAN, the employed Bluetooth profile (SPP (serial port profile orHDP (health device profile, the use of other peripherals, such as a GPS receiver, the impactof the use of theWi-Fi interface or the employed method to encode and forward the data thatare collected from the sensors.

System Reliability Analysis Capability and Surrogate Model Application in RAVEN

Energy Technology Data Exchange (ETDEWEB)

Rabiti, Cristian [Idaho National Lab. (INL), Idaho Falls, ID (United States); Alfonsi, Andrea [Idaho National Lab. (INL), Idaho Falls, ID (United States); Huang, Dongli [Idaho National Lab. (INL), Idaho Falls, ID (United States); Gleicher, Frederick [Idaho National Lab. (INL), Idaho Falls, ID (United States); Wang, Bei [Idaho National Lab. (INL), Idaho Falls, ID (United States); Adbel-Khalik, Hany S. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Pascucci, Valerio [Idaho National Lab. (INL), Idaho Falls, ID (United States); Smith, Curtis L. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2015-11-01

This report collect the effort performed to improve the reliability analysis capabilities of the RAVEN code and explore new opportunity in the usage of surrogate model by extending the current RAVEN capabilities to multi physics surrogate models and construction of surrogate models for high dimensionality fields.

Identifying challenges for academic leadership in medical universities in Iran.

Science.gov (United States)

Bikmoradi, Ali; Brommels, Mats; Shoghli, Alireza; Khorasani-Zavareh, Davoud; Masiello, Italo

2010-05-01

CONTEXT The crucial role of academic leadership in the success of higher education institutions is well documented. Medical education in Iran has been integrated into the health care system through a complex organisational change. This has called into question the current academic leadership, making Iranian medical universities and schools a good case for exploring the challenges of academic leadership. OBJECTIVES This study explores the leadership challenges perceived by academic managers in medical schools and universities in Iran. METHODS A qualitative study using 18 face-to-face, in-depth interviews with academic managers in medical universities and at the Ministry of Health and Medical Education in Iran was performed. All interviews were recorded digitally, transcribed verbatim and analysed by qualitative content analysis. RESULTS The main challenges to academic leadership could be categorised under three themes, each of which included three sub-themes: organisational issues (inefficacy of academic governance; an overly extensive set of missions and responsibilities; concerns about the selection of managers); managerial issues (management styles; mismatch between authority and responsibilities; leadership capabilities), and organisational culture (tendency towards governmental management; a boss-centred culture; low motivation). CONCLUSIONS This study emphasises the need for academic leadership development in Iranian medical schools and universities. The ability of Iranian universities to grow and thrive will depend ultimately upon the application of leadership skills. Thus, it is necessary to better designate authorities, roles of academic staff and leaders at governance.

Occupational Therapists’ Perceived Relevance of Nussbaum’s Central Capabilities to Client-centered Practice

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Tahmineh Mousavi

2015-10-01

Full Text Available Background: Client-centered practice is highly valued in occupational therapy. Nussbaum’s Capabilities Approach focuses on the individual person and functional autonomy by encompassing 10 functional capabilities that could provide a framework for the systematic implementation of client-centered care. Method: To explore the perceived relevance of Nussbaum’s 10 capabilities with respect to client-centered practice, semi-structured interviews with 14 occupational therapists in British Columbia, Canada, were conducted and thematically analyzed. Results: Nussbaum’s Central Human Functional Capabilities approach provides a broad perspective, encompassing the range of settings of occupational therapy practice. Nussbaum’s 10 capabilities were viewed as being particularly aligned with the established tenets of client-centered practice. Conclusion: Nussbaum’s Capabilities Approach has several compelling attributes for consideration by occupational therapists that warrant further exploration as a novel basis for systematically implementing client-centered care.

Social media and medical education: Exploring the potential of Twitter as a learning tool.

Science.gov (United States)

Jalali, Alireza; Sherbino, Jonathan; Frank, Jason; Sutherland, Stephanie

2015-04-01

This study set out to explore the ways in which social media can facilitate learning in medical education. In particular we were interested in determining whether the use of Twitter during an academic conference can promote learning for participants. The Twitter transcript from the annual International Conference on Residency Education (ICRE) 2013 was qualitatively analysed for evidence of the three overarching cognitive themes: (1) preconceptions, (2) frameworks, and (3) metacognition/refl ection in regard to the National Research Council ’ s (NRC) How People Learn framework . Content analysis of the Twitter transcript revealed evidence of the three cognitive themes as related to how people learn. Twitter appears to be most effective at stimulating individuals ’ preconceptions, thereby engaging them with the new material acquired during a medical education conference. The study of social media data, such as the Twitter data used in this study, is in its infancy. Having established that Twitter does hold signifi cant potential as a learning tool during an academic conference, we are now in a better position to more closely examine the spread, depth, and sustainability of such learning during medical education meetings.

An Evidence Based Approach to Designing Medical Support for Long Duration, Interplanetary Missions

Science.gov (United States)

Watkins, S. D.; McGrath, T. L.; Bauman, D. K.; Wu, J. H.; Barsten, K. N.; Barr, Y. R.; Kerstman, E. L.

2011-01-01

The Exploration Medical Capability (ExMC) element is one of six elements under NASA's Human Research Program (HRP). The goal of the ExMC element is to address the risk of the "inability to adequately recognize or treat an ill or injured crewmember." This poster highlights the evidence-based approach that the ExMC element has taken to address this goal, and the ExMC element's current areas of interest.

Human Exploration Mission Capabilities to the Moon, Mars, and Near Earth Asteroids Using ''Bimodal'' NTR Propulsion

International Nuclear Information System (INIS)

Stanley K. Borowski; Leonard A. Dudzinski; Melissa L. McGuire

2000-01-01

The nuclear thermal rocket (NTR) is one of the leading propulsion options for future human exploration missions because of its high specific impulse (Isp ∼ 850 to 1000 s) and attractive engine thrust-to-weight ratio (∼ 3 to 10). Because only a minuscule amount of enriched 235 U fuel is consumed in an NRT during the primary propulsion maneuvers of a typical Mars mission, engines configured both for propulsive thrust and modest power generation (referred to as 'bimodal' operation) provide the basis for a robust, power-rich stage with efficient propulsive capture capability at the moon and near-earth asteroids (NEAs), where aerobraking cannot be utilized. A family of modular bimodal NTR (BNTR) space transfer vehicles utilize a common core stage powered by three ∼15-klb f engines that produce 50 kW(electric) of total electrical power for crew life support, high data rate communications with Earth, and an active refrigeration system for long-term, zero-boiloff liquid hydrogen (LH 2 ) storage. This paper describes details of BNTR engines and designs of vehicles using them for various missions

Organizational Learning Capability: An Example of University Hospital

Directory of Open Access Journals (Sweden)

Yasin UZUNTARLA

2015-06-01

Full Text Available In health care institutions aiming healthy society by the way protecting and promoting human health, reaching information has a vital importance. This descriptive research purposed an evaluation of organizational learning capability of 396 employees working in Gülhane Military Medical Academy Hospital. A questionnaire including socio-demographic characteristics was used along with Organizational Learning Capability scale designed by Ricardo CHIVA and His Friends. Data acquired was analyzed with SPSS 15.0 program. Participants’ Organizational Learning Capability and its subscales means were assessed in terms of their sociodemographic characteristics. Assessing participants’ answers in terms of 5 subscales which are experimentation, risk taking, interaction with the external environment, dialogue and participatory decision-making; for education level and professional groups, statistical significant differences was found between Organizational Learning Capability and its subscales means.

Perceived stress at transition to workplace: a qualitative interview study exploring final-year medical students’ needs

Directory of Open Access Journals (Sweden)

Moczko TR

2016-01-01

Full Text Available Tobias R Moczko,1,2,* Till J Bugaj,1,* Wolfgang Herzog,1 Christoph Nikendei1 1Department for General Internal and Psychosomatic Medicine, University Hospital of Heidelberg, Heidelberg, 2School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany *These authors contributed equally to this work Objectives: This study was designed to explore final-year medical students’ stressors and coping strategies at the transition to the clinical workplace. Methods: In this qualitative study, semi-standardized interviews with eight final-year medical students (five male, three female; aged 25.9±1.4 years were conducted during their internal medicine rotation. After verbatim transcription, a qualitative content analysis of students’ impressions of stress provoking and easing factors during final-year education was performed. Results: Students’ statements regarding burdens and dealing with stress were classified into four main categories: A perceived stressors and provoking factors, B stress-induced consequences, C personal and external resources for preventing and dealing with stress, and D final-year students’ suggestions for workplace improvement. Conclusion: Final-year medical students perceived different types of stress during their transition to medical wards, and reported both negative consequences and coping resources concerning perceived stress. As supervision, feedback, and coping strategies played an important role in the students’ perception of stress, final-year medical education curricula development should focus on these specifically. Keywords: undergraduate medical education, stress prevention, final-year medical education, workplace learning, qualitative research

Exploring Leadership Capability Team Leaders for Construction Industry in Malaysia: Training and Experience

Science.gov (United States)

Muda, W. H. N. Wan; Halim, F. Ab; Libunao, W. H.

2017-08-01

It has been said that the construction industry must unleash its potential as a source of wealth creation and provide opportunity for the betterment of quality of life. In ensuring the quality of workmanship at construction sites, supervisory skills of site supervisors need to be enhanced. It stressed out that to match business growth and excellence overseas, we must recognize and act on the importance of continuously developing niche expertise and capabilities. Undoubtedly, the role of research in determining the specific leadership skills and the needed core capabilities cannot be over-emphasized. In ensuring the quality of workmanship at construction sites, leadership skills especially supervisory skill for site supervisors need to be enhanced. In this study, quantitative research design with survey questionnaire was used to collect the data and simple random sampling was employed in selecting 248 respondents involving team leaders in construction industry from whole of Malaysia. The data was analyzed using descriptive and inferential statistics; ANOVA in SPSS 21.0. Training and experience in leadership has been found to be significance to leadership capability of team leaders. The opinions from the respondents also indicated that they need the training of leadership and they had to enhance themselves to enable them to become better and more competitive leaders. The results of this assessment can pinpoint the areas needing improvement and therefore can be used as basis in designing and/or deciding development programmes. This study also found that generally the team leaders in construction industry needed more opportunities to expand their leadership capability to become the effective leaders in future.

Vital Signs Monitoring System Using Radio Frequency Communication: A Medical Care Terminal for Beddridden People Support

Directory of Open Access Journals (Sweden)

Fábio FERREIRA

2015-02-01

Full Text Available In this paper, the data transmission of an acquisition system for biomedical vital signs via Radio Frequency (RF communication is explored. This system can be considered a medical care terminal (MCT. It was developed a platform capable of recording the patient's physiological signals to check if any medical evolution/change occurred. The system allows also acquiring the environment data, as for example the room temperature and luminosity. The main achievement of this paper is the patients’ real-time health condition monitoring by the medical personnel or caregivers that will contribute to prevent health problems, especially for bedridden people with reduced mobility.

An eHealth Capabilities Framework for Graduates and Health Professionals: Mixed-Methods Study.

Science.gov (United States)

Brunner, Melissa; McGregor, Deborah; Keep, Melanie; Janssen, Anna; Spallek, Heiko; Quinn, Deleana; Jones, Aaron; Tseris, Emma; Yeung, Wilson; Togher, Leanne; Solman, Annette; Shaw, Tim

2018-05-15

The demand for an eHealth-ready and adaptable workforce is placing increasing pressure on universities to deliver eHealth education. At present, eHealth education is largely focused on components of eHealth rather than considering a curriculum-wide approach. This study aimed to develop a framework that could be used to guide health curriculum design based on current evidence, and stakeholder perceptions of eHealth capabilities expected of tertiary health graduates. A 3-phase, mixed-methods approach incorporated the results of a literature review, focus groups, and a Delphi process to develop a framework of eHealth capability statements. Participants (N=39) with expertise or experience in eHealth education, practice, or policy provided feedback on the proposed framework, and following the fourth iteration of this process, consensus was achieved. The final framework consisted of 4 higher-level capability statements that describe the learning outcomes expected of university graduates across the domains of (1) digital health technologies, systems, and policies; (2) clinical practice; (3) data analysis and knowledge creation; and (4) technology implementation and codesign. Across the capability statements are 40 performance cues that provide examples of how these capabilities might be demonstrated. The results of this study inform a cross-faculty eHealth curriculum that aligns with workforce expectations. There is a need for educational curriculum to reinforce existing eHealth capabilities, adapt existing capabilities to make them transferable to novel eHealth contexts, and introduce new learning opportunities for interactions with technologies within education and practice encounters. As such, the capability framework developed may assist in the application of eHealth by emerging and existing health care professionals. Future research needs to explore the potential for integration of findings into workforce development programs. ©Melissa Brunner, Deborah Mc

Risk of Adverse Health Outcomes and Decrements in Performance Due to In-flight Medical Conditions

Science.gov (United States)

Antonsen,Erik

2017-01-01

The drive to undertake long-duration space exploration missions at greater distances from Earth gives rise to many challenges concerning human performance under extreme conditions. At NASA, the Human Research Program (HRP) has been established to investigate the specific risks to astronaut health and performance presented by space exploration, in addition to developing necessary countermeasures and technology to reduce risk and facilitate safer, more productive missions in space (NASA Human Research Program 2009). The HRP is divided into five subsections, covering behavioral health, space radiation, habitability, and other areas of interest. Within this structure is the ExMC Element, whose research contributes to the overall development of new technologies to overcome the challenges of expanding human exploration and habitation of space. The risk statement provided by the HRP to the ExMC Element states: "Given that medical conditions/events will occur during human spaceflight missions, there is a possibility of adverse health outcomes and decrements in performance in mission and for long term health" (NASA Human Research Program 2016). Within this risk context, the Exploration Medical Capabilities (ExMC) Element is specifically concerned with establishing evidenced-based methods of monitoring and maintaining astronaut health. Essential to completing this task is the advancement in techniques that identify, prevent, and treat any health threats that may occur during space missions. The ultimate goal of the ExMC Element is to develop and demonstrate a pathway for medical system integration into vehicle and mission design to mitigate the risk of medical issues. Integral to this effort is inclusion of an evidence-based medical and data handling system appropriate for long-duration, exploration-class missions. This requires a clear Concept of Operations, quantitative risk metrics or other tools to address changing risk throughout a mission, and system scoping and system

The Application of LENR to Synergistic Mission Capabilities

Science.gov (United States)

Wells, Douglas P.; Mavris, Dimitri N.

2014-01-01

This paper presents an overview of several missions that exploit the capabilities of a Low Energy Nuclear Reaction (LENR) aircraft propulsion system. LENR is a form of nuclear energy and potentially has over 4,000 times the energy density of chemical energy sources. It does not have any harmful emissions or radiation which makes it extremely appealing. The global reliance on crude oil for aircraft energy creates the opportunity for a revolutionary change with LENR. LENR will impact aircraft performance capabilities, military capabilities, the environment, the economy, and society. Although there is a lot of interest in LENR, there is no proven theory that explains it. Some of the technical challenges are thermal runaway and start-up time. This paper does not explore the feasibility of LENR and assumes that a system is available. A non-dimensional aircraft mass (NAM) ratio diagram is used to explore the aircraft system design space. The NAM ratio diagram shows that LENR can enable long range and high speed missions. The design space exploration led to the conclusion that LENR aircraft would be well suited for high altitude long endurance (HALE) missions, including communications relay and scientific missions for hurricane tracking and other weather phenomena, military intelligence, surveillance, and reconnaissance (ISR) and airspace denial missions, supersonic passenger transport aircraft, and international cargo transport. This paper describes six of those missions.

Investments by NASA to build planetary protection capability

Science.gov (United States)

Buxbaum, Karen; Conley, Catharine; Lin, Ying; Hayati, Samad

NASA continues to invest in capabilities that will enable or enhance planetary protection planning and implementation for future missions. These investments are critical to the Mars Exploration Program and will be increasingly important as missions are planned for exploration of the outer planets and their icy moons. Since the last COSPAR Congress, there has been an opportunity to respond to the advice of NRC-PREVCOM and the analysis of the MEPAG Special Regions Science Analysis Group. This stimulated research into such things as expanded bioburden reduction options, modern molecular assays and genetic inventory capability, and approaches to understand or avoid recontamination of spacecraft parts and samples. Within NASA, a portfolio of PP research efforts has been supported through the NASA Office of Planetary Protection, the Mars Technology Program, and the Mars Program Office. The investment strategy focuses on technology investments designed to enable future missions and reduce their costs. In this presentation we will provide an update on research and development supported by NASA to enhance planetary protection capability. Copyright 2008 California Institute of Technology. Government sponsorship acknowledged.

The Ares Launch Vehicles: Critical Capabilities for America's Continued Leadership in Space

Science.gov (United States)

Cook, Stephen A.

2009-01-01

The Constellation Program renews the nation's commitment to human space exploration a) Access to ISS. b) Human explorers to the Moon and beyond. c) Large telescopes and other hardware to LEO . Hardware is being built today. Development made easier by applying lessons learned from 50 years of spaceflight experience. Ares V heavy-lift capability will be a strategic asset for the nation. Constellation provides a means for world leadership through inspiration and strategic capability.

User Oriented Platform for Data Analytics in Medical Imaging Repositories.

Science.gov (United States)

Valerio, Miguel; Godinho, Tiago Marques; Costa, Carlos

2016-01-01

The production of medical imaging studies and associated data has been growing in the last decades. Their primary use is to support medical diagnosis and treatment processes. However, the secondary use of the tremendous amount of stored data is generally more limited. Nowadays, medical imaging repositories have turned into rich databanks holding not only the images themselves, but also a wide range of metadata related to the medical practice. Exploring these repositories through data analysis and business intelligence techniques has the potential of increasing the efficiency and quality of the medical practice. Nevertheless, the continuous production of tremendous amounts of data makes their analysis difficult by conventional approaches. This article proposes a novel automated methodology to derive knowledge from medical imaging repositories that does not disrupt the regular medical practice. Our method is able to apply statistical analysis and business intelligence techniques directly on top of live institutional repositories. It is a Web-based solution that provides extensive dashboard capabilities, including complete charting and reporting options, combined with data mining components. Moreover, it enables the operator to set a wide multitude of query parameters and operators through the use of an intuitive graphical interface.

Medical Robots: Current Systems and Research Directions

Directory of Open Access Journals (Sweden)

Ryan A. Beasley

2012-01-01

Full Text Available First used medically in 1985, robots now make an impact in laparoscopy, neurosurgery, orthopedic surgery, emergency response, and various other medical disciplines. This paper provides a review of medical robot history and surveys the capabilities of current medical robot systems, primarily focusing on commercially available systems while covering a few prominent research projects. By examining robotic systems across time and disciplines, trends are discernible that imply future capabilities of medical robots, for example, increased usage of intraoperative images, improved robot arm design, and haptic feedback to guide the surgeon.

Firm Performance and Alliance Capability: The mediating role of culture

NARCIS (Netherlands)

de Man, A.P.; Luvison, D.

2015-01-01

Purpose – Extant literature has looked at the effect of alliance capability and organizational culture on alliance portfolio performance, but the relationship between the two has not been explored. The purpose of this paper is to explore the hypothesis that an alliance supportive culture is not only

The Greater Sekhukhune-CAPABILITY outreach project.

Science.gov (United States)

Gregersen, Nerine; Lampret, Julie; Lane, Tony; Christianson, Arnold

2013-07-01

The Greater Sekhukhune-CAPABILITY Outreach Project was undertaken in a rural district in Limpopo, South Africa, as part of the European Union-funded CAPABILITY programme to investigate approaches for capacity building for the translation of genetic knowledge into care and prevention of congenital disorders. Based on previous experience of a clinical genetic outreach programme in Limpopo, it aimed to initiate a district clinical genetic service in Greater Sekhukhune to gain knowledge and experience to assist in the implementation and development of medical genetic services in South Africa. Implementing the service in Greater Sekhukhune was impeded by a developing staff shortage in the province and pressure on the health service from the existing HIV/AIDS and TB epidemics. This situation underscores the need for health needs assessment for developing services for the care and prevention of congenital disorders in middle- and low-income countries. However, these impediments stimulated the pioneering of innovate ways to offer medical genetic services in these circumstances, including tele-teaching of nurses and doctors, using cellular phones to enhance clinical care and adapting and assessing the clinical utility of a laboratory test, QF-PCR, for use in the local circumstances.

Characteristics of the Capable Teacher from the Viewpoint of the Students at Faculty of Health, Guilan University of Medical Sciences in 2013

Directory of Open Access Journals (Sweden)

Fardin Mehrabian

2014-09-01

Full Text Available Teachers are responsible for teaching the students, and improving the teaching quality plays an essential role in the efficiency of the student and teacher. The present study was a descriptive cross-sectional study with a total research sample of 220 people that investigated the characteristics of the capable teacher from the viewpoint of the students at faculty of health, Guilan University of Medical Sciences using census method. Data collection tool was a 24-item questionnaire. The validity of the questionnaire was determined through content validity and its reliability was calculated by Cronbach’s alpha (r=0.87. The collected data were analyzed by SPSS software using descriptive statistics. The most important characteristics of capable teachers from the viewpoint of the students included being knowledgable (90.5%, interest in teaching (78.9%, eloquent presentation (77.3%, accepting criticism (75.5% and flexibility (71.4%, respectively. It is necessary to take these characteristics into consideration while recruiting the faculty members and planning for faculty developement programms.

Evaluating Internal Technological Capabilities in Energy Companies

Directory of Open Access Journals (Sweden)

Mingook Lee

2016-03-01

Full Text Available As global competition increases, technological capability must be evaluated objectively as one of the most important factors for predominance in technological competition and to ensure sustainable business excellence. Most existing capability evaluation models utilize either quantitative methods, such as patent analysis, or qualitative methods, such as expert panels. Accordingly, they may be in danger of reflecting only fragmentary aspects of technological capabilities, and produce inconsistent results when different models are used. To solve these problems, this paper proposes a comprehensive framework for evaluating technological capabilities in energy companies by considering the complex properties of technological knowledge. For this purpose, we first explored various factors affecting technological capabilities and divided the factors into three categories: individual, organizational, and technology competitiveness. Second, we identified appropriate evaluation items for each category to measure the technological capability. Finally, by using a hybrid approach of qualitative and quantitative methods, we developed an evaluation method for each item and suggested a method to combine the results. The proposed framework was then verified with an energy generation and supply company to investigate its practicality. As one of the earliest attempts to evaluate multi-faceted technological capabilities, the suggested model can support technology and strategic planning.

Medical students' note-taking in a medical biochemistry course: an initial exploration.

Science.gov (United States)

Morrison, Elizabeth H; McLaughlin, Calvin; Rucker, Lloyd

2002-04-01

Beginning medical students spend numerous hours every week attending basic science lectures and taking notes. Medical faculty often wonder whether they should give students pre-printed instructors' notes before lectures. Proponents of this strategy argue that provided notes enhance learning by facilitating the accurate transmission of information, while opponents counter that provided notes inhibit students' cognitive processing or even discourage students from attending lectures. Little if any research has directly addressed medical students' note-taking or the value of providing instructors' notes. The educational literature does suggest that taking lecture notes enhances university students' learning. University students perform best on post-lecture testing if they review a combination of provided notes and their own personal notes, particularly if the provided notes follow a 'skeletal' format that encourages active note-taking.

A Qualitative Exploration of the Help-Seeking Behaviors of Students Who Experience Psychological Distress Around Assessment at Medical School.

Science.gov (United States)

Winter, Rachel I; Patel, Rakesh; Norman, Robert I

2017-08-01

Medical students are at high risk of experiencing psychological distress at medical school and developing mental ill-health during professional practice. Despite efforts by faculty to raise awareness about this risk, many students choose to suffer in silence in the face of psychological distress. The aim of this study was to explore drivers that prompted help-seeking behavior and barriers that prevented individuals prioritizing their well-being around the time of high-stakes assessment at medical school. Semi-structured interviews were conducted with fifty-seven students who failed high-stakes assessment at two UK medical schools, exploring their experience of academic difficulty and perceptions about causes. A thematic analysis of twenty transcripts that met inclusion criteria was completed to identify key factors that influenced participants' decisions around seeking help for their psychological distress, and in some cases, mental health problems. Twenty participants who specifically described a deterioration in their mental health around the time of assessment were included in this study. Barriers to seeking help in these instances included: normalization of symptoms or situation; failure to recognize a problem existed; fear of stigmatisation; overt symptoms of mental distress; and misconceptions about the true nature of the medical school, for example beliefs about a punitive response from the school if they failed. Drivers for seeking help appropriately included: building trust with someone in order to confide in them later on, and self-awareness about the need to maintain good mental health. There are various drivers and barriers for students' help seeking behaviors when experiencing psychological distress around the time of assessment, particularly self-awareness about the problem and prioritisation of well-being. Students who fail to recognize their own deteriorating mental health are at risk of academic failure and medical schools need to develop

Autonomous, In-Flight Crew Health Risk Management for Exploration-Class Missions: Leveraging the Integrated Medical Model for the Exploration Medical System Demonstration Project

Science.gov (United States)

Butler, D. J.; Kerstman, E.; Saile, L.; Myers, J.; Walton, M.; Lopez, V.; McGrath, T.

2011-01-01

The Integrated Medical Model (IMM) captures organizational knowledge across the space medicine, training, operations, engineering, and research domains. IMM uses this knowledge in the context of a mission and crew profile to forecast risks to crew health and mission success. The IMM establishes a quantified, statistical relationship among medical conditions, risk factors, available medical resources, and crew health and mission outcomes. These relationships may provide an appropriate foundation for developing an in-flight medical decision support tool that helps optimize the use of medical resources and assists in overall crew health management by an autonomous crew with extremely limited interactions with ground support personnel and no chance of resupply.

Compact Neutron Generators for Medical, Home Land Security, and Planetary Exploration

CERN Document Server

Reijonen, Jani

2005-01-01

The Plasma and Ion Source Technology Group at Lawrence Berkeley National Laboratory has developed various types of advanced D-D (neutron energy 2.5 MeV), D-T (14 MeV) and T-T (0 - 9 MeV) neutron generators for wide range of applications. These applications include medical (Boron Neutron Capture Therapy), homeland security (Prompt Gamma Activation Analysis, Fast Neutron Activation Analysis and Pulsed Fast Neutron Transmission Spectroscopy) and planetary exploration in form of neutron based, sub-surface hydrogen detection systems. These neutron generators utilize RF induction discharge to ionize the deuterium/tritium gas. This discharge method provides high plasma density for high output current, high atomic species from molecular gases, long life operation and versatility for various discharge chamber geometries. Three main neutron generator developments are discussed here: high neutron output co-axial neutron generator for BNCT applications, point neutron generator for security applications, compact and sub-c...

Learning Capability and Business Performance: A Non-Financial and Financial Assessment

Science.gov (United States)

Ma Prieto, Isabel; Revilla, Elena

2006-01-01

Purpose: There has been little research that includes reliable deductions about the positive influence of learning capability on business performance. For this reason, the main objective of the present study is to empirically explore the link between learning capability in organizations and business performance evaluated in both financial and…

Exploring the attitudes of medical faculty members and students in Pakistan towards plagiarism: a cross sectional survey

Science.gov (United States)

Rathore, Farooq Azam; Zia, Ahmad Marjan; Mavrinac, Martina; Farooq, Fareeha

2015-01-01

Objective. The objective of this survey was to explore the attitudes towards plagiarism of faculty members and medical students in Pakistan. Methods. The Attitudes Toward Plagiarism questionnaire (ATP) was modified and distributed among 550 medical students and 130 faculty members in 7 medical colleges of Lahore and Rawalpindi. Data was entered in the SPSS v.20 and descriptive statistics were analyzed. The questionnaire was validated by principal axis factoring analysis. Results. Response rate was 93% and 73%, respectively. Principal axis factoring analysis confirmed one factor structure of ATP in the present sample. It had an acceptable Cronbach’s alpha value of 0.73. There were 421 medical students (218 (52%) female, 46% 3rd year MBBS students, mean age of 20.93 ± 1.4 years) and 95 faculty members (54.7% female, mean age 34.5 ± 8.9 years). One fifth of the students (19.7%) trained in medical writing (19.7%), research ethics (25.2%) or were currently involved in medical writing (17.6%). Most of the faculty members were demonstrators (66) or assistant professors (20) with work experience between 1 and 10 years. Most of them had trained in medical writing (68), research ethics (64) and were currently involved in medical writing (64). Medical students and faculty members had a mean score of 43.21 (7.1) and 48.4 (5.9) respectively on ATP. Most of the respondents did not consider that they worked in a plagiarism free environment and reported that self-plagiarism should not be punishable in the same way as plagiarism. Opinion regarding leniency in punishment of younger researchers who were just learning medical writing was divided. Conclusions. The general attitudes of Pakistani medical faculty members and medical students as assessed by ATP were positive. We propose training in medical writing and research ethics as part of the under and post graduate medical curriculum. PMID:26157615

Equipment for nuclear medical centers, production capabilities of Rosatom enterprises

International Nuclear Information System (INIS)

Gavrish, Yu. N.; Koloskov, S. A.; Smirnov, V. P.; Strokach, A. P.

2015-01-01

Analysis of the capabilities of the State Corporation Rosatom enterprises on the development and production of diagnostic and therapeutic equipment for nuclear medicine centers is presented. Prospects of the development of accelerator equipment for the production of a wide range of radioisotope products are shown, and the trends of its development are determined. A comparative analysis of the technical parameters of domestic tomographs and devices for brachytherapy with foreign counterparts is given

Equipment for nuclear medical centers, production capabilities of Rosatom enterprises

Science.gov (United States)

Gavrish, Yu. N.; Koloskov, S. A.; Smirnov, V. P.; Strokach, A. P.

2015-12-01

Analysis of the capabilities of the State Corporation Rosatom enterprises on the development and production of diagnostic and therapeutic equipment for nuclear medicine centers is presented. Prospects of the development of accelerator equipment for the production of a wide range of radioisotope products are shown, and the trends of its development are determined. A comparative analysis of the technical parameters of domestic tomographs and devices for brachytherapy with foreign counterparts is given.

Developing Acquisition IS Integration Capabilities

DEFF Research Database (Denmark)

Wynne, Peter J.

2016-01-01

An under researched, yet critical challenge of Mergers and Acquisitions (M&A), is what to do with the two organisations’ information systems (IS) post-acquisition. Commonly referred to as acquisition IS integration, existing theory suggests that to integrate the information systems successfully......, an acquiring company must leverage two high level capabilities: diagnosis and integration execution. Through a case study, this paper identifies how a novice acquirer develops these capabilities in anticipation of an acquisition by examining its use of learning processes. The study finds the novice acquirer...... applies trial and error, experimental, and vicarious learning processes, while actively avoiding improvisational learning. The results of the study contribute to the acquisition IS integration literature specifically by exploring it from a new perspective: the learning processes used by novice acquirers...

Exploring talent development environments –inspirations to medical education at doctoral level

DEFF Research Database (Denmark)

Christensen, Mette Krogh; Lund, Ole; Mørcke, Anne Mette

Introduction: Doctoral students may be considered some of our most talented students. In order to maintain high quality in doctoral education we should be aware of optimizing the talent development environment in which the students develop their competencies. In this paper we explore the features...... has been on cognitive skills of individual talents and to a minor degree on institutional conditions and constraints within talent development environments. However, recent studies on talent development in sport recognize ‘talent’ as a social construction (1) and institutional and environmental...... features playing a decisive role in talent development (2). Our research question is: do concepts and models for talent development environments in sport apply to medical education at doctoral level? Considering the uniqueness of the two domains (they refer to different overall social fields: education...

Does Wearable Medical Technology With Video Recording Capability Add Value to On-Call Surgical Evaluations?

Science.gov (United States)

Gupta, Sameer; Boehme, Jacqueline; Manser, Kelly; Dewar, Jannine; Miller, Amie; Siddiqui, Gina; Schwaitzberg, Steven D

2016-10-01

Background Google Glass has been used in a variety of medical settings with promising results. We explored the use and potential value of an asynchronous, near-real time protocol-which avoids transmission issues associated with real-time applications-for recording, uploading, and viewing of high-definition (HD) visual media in the emergency department (ED) to facilitate remote surgical consults. Study Design First-responder physician assistants captured pertinent aspects of the physical examination and diagnostic imaging using Google Glass' HD video or high-resolution photographs. This visual media were then securely uploaded to the study website. The surgical consultation then proceeded over the phone in the usual fashion and a clinical decision was made. The surgeon then accessed the study website to review the uploaded video. This was followed by a questionnaire regarding how the additional data impacted the consultation. Results The management plan changed in 24% (11) of cases after surgeons viewed the video. Five of these plans involved decision making regarding operative intervention. Although surgeons were generally confident in their initial management plan, confidence scores increased further in 44% (20) of cases. In addition, we surveyed 276 ED patients on their opinions regarding concerning the practice of health care providers wearing and using recording devices in the ED. The survey results revealed that the majority of patients are amenable to the addition of wearable technology with video functionality to their care. Conclusions This study demonstrates the potential value of a medically dedicated, hands-free, HD recording device with internet connectivity in facilitating remote surgical consultation. © The Author(s) 2016.

Heavy Lift Launch Capability with a New Hydrocarbon Engine (NHE)

Science.gov (United States)

Threet, Grady E., Jr.; Holt, James B.; Philips, Alan D.; Garcia, Jessica A.

2011-01-01

The Advanced Concepts Office (ACO) at NASA Marshall Space Flight Center has analyzed over 2000 Ares V and other heavy lift concepts in the last 3 years. These concepts were analyzed for Lunar Exploration Missions, heavy lift capability to Low Earth Orbit (LEO) as well as exploratory missions to other near earth objects in our solar system. With the pending retirement of the Shuttle fleet, our nation will be without a civil heavy lift launch capability, so the future development of a new heavy lift capability is imperative for the exploration and large science missions our Agency has been tasked to deliver. The majority of the heavy lift concepts analyzed by ACO during the last 3 years have been based on liquid oxygen / liquid hydrogen (LOX/LH2) core stage and solids booster stage propulsion technologies (Ares V / Shuttle Derived and their variants). These concepts were driven by the decisions made from the results of the Exploration Systems Architecture Study (ESAS), which in turn, led to the Ares V launch vehicle that has been baselined in the Constellation Program. Now that the decision has been made at the Agency level to cancel Constellation, other propulsion options such as liquid hydrocarbon fuels are back in the exploration trade space. NASA is still planning exploration missions with the eventual destination of Mars and a new heavy lift launch vehicle is still required and will serve as the centerpiece of our nation s next exploration architecture s infrastructure. With an extensive launch vehicle database already developed on LOX/LH2 based heavy lift launch vehicles, ACO initiated a study to look at using a new high thrust (> 1.0 Mlb vacuum thrust) hydrocarbon engine as the primary main stage propulsion in such a launch vehicle.

Dynamic capabilities, creative action, and poetics

Directory of Open Access Journals (Sweden)

Donald MacLean

2017-05-01

Full Text Available Research on dynamic capabilities explores how businesses change enables enterprises to remain competitive. However, theory on dynamic capabilities still struggles to capture novelty, the essence of change. This study argues that a full understanding of strategic change requires us to sharpen our focus on real people and experiences; in turn, we must incorporate other faculties, which almost always operate alongside our logical ones, into our theory. We must pay more attention to the “non­-rational” sides of ourselves—including, but not limited to, our imaginations, intuitions, attractions, biographies, preferences, and aesthetic faculties and capabilities. We argue that all such faculties, on the one hand, are central to our abilities to comprehend and cope with complexity and, on the other hand, foster novel understandings, potential responses, and social creativity. This study intro­duces the possibility of an alternative form of inquiry that highlights the role of poetic faculties in strategic behavior and change.

Designing Tools for Ocean Exploration. Galapagos Rifts Expedition--Grades 9-12. Overview: Ocean Exploration.

Science.gov (United States)

National Oceanic and Atmospheric Administration (DOC), Rockville, MD.

This activity teaches about the complexity of ocean exploration, the technological applications and capabilities required for ocean exploration, the importance of teamwork in scientific research projects, and developing abilities necessary to do scientific inquiry. The activity provides learning objectives, a list of needed materials, key…

Exploring the ideas and expectations of German medical students towards career choices and the speciality of psychiatry.

Science.gov (United States)

Baller, Frauke A E; Ludwig, Karin V; Kinas-Gnadt Olivares, Clara L; Graef-Calliess, Iris-Tatjana

2013-08-01

The aim of this study was to explore the ideas and expectations of medical students toward their career choices and the speciality of psychiatry. A total of 323 students of the Hannover Medical School filled in a questionnaire about their career choices, preferred medical specialization, factors of influence on career choices and attitude towards psychiatry. The three most important factors of influence appeared to be: (1) work-life balance, (2) flexible working hours, (3) career prospects. Although expectations towards the professional life of psychiatrists were quite positive among the students, there was only a small number of students (n = 53 of 318 respondents, 17%) interested in specializing in psychiatry. Important reasons for choosing psychiatry included personal experience with somatic or mental health issues and practical experience in psychiatry. Most of the students experienced clinical exposure to psychiatry but at a much later period in the curriculum. For a career choice of psychiatry as a speciality it seems to be important to start psychiatric education in medical school early. The positive aspects of the professional life in psychiatry, such as flexible working hours, career prospects and good work-life balance should be more emphasized.

An exploration of changes in cognitive and emotional empathy among medical students in the Caribbean

Science.gov (United States)

Youssef, Farid F.; Nunes, Paula; Sa, Bidyadhar; Williams, Stella

2014-01-01

Objectives: This study explored the empathy profile of students across five years of medical training. In addition the study examined whether the Jefferson Scale for Physician Empathy correlated with a measure of cognitive empathy, the Reading the Mind in the Eyes Test and a measure of affective empathy, the Toronto Empathy Questionnaire. Methods: The study was a comparative cross-sectional design at one Caribbean medical school. Students were contacted in class, participation was voluntary and empathy was assessed using all three instruments Descriptive statistics were calculated and differences between groups evaluated using non-parametric tests. Results: Overall 669 students participated (response rate, 67%). There was a significant correlation between the Jefferson Scale of Physician Empathy and the Toronto Empathy Questionnaire (P = 0.48), both scales indicating a decline in medical student empathy scores over time. There was, however, little correlation between scores from the Reading the Mind in the Eyes Test and the Jefferson Scale of Physician Empathy. Female students demonstrated significantly higher scores on all three measures. Conclusions: Medical students’ lower empathy scores during their final years of training appear to be due to a change in the affective component of empathy. These findings may reflect an adaptive neurobiological response to the stressors associated with encountering new clinical situations. Attention should be paid not only to providing empathy training for students but also to teaching strategies for improved cognitive processing capacity when they are encountering new and challenging circumstances. PMID:25341229

Web-Based Medical Service: Technology Attractiveness, Medical Creditability, Information Source, and Behavior Intention.

Science.gov (United States)

Wang, Shan Huei

2017-08-02

Web-based medical service (WBMS), a cooperative relationship between medical service and Internet technology, has been called one of the most innovative services of the 21st century. However, its business promotion and implementation in the medical industry have neither been expected nor executed. Few studies have explored this phenomenon from the viewpoint of inexperienced patients. The primary goal of this study was to explore whether technology attractiveness, medical creditability, and diversified medical information sources could increase users' behavior intention. This study explored the effectiveness of web-based medical service by using three situations to manipulate sources of medical information. A total of 150 questionnaires were collected from people who had never used WBMS before. Hierarchical regression was used to examine the mediation and moderated-mediation effects. Perceived ease of use (P=.002) and perceived usefulness (P=.001) significantly enhance behavior intentions. Medical credibility is a mediator (P=.03), but the relationship does not significantly differ under diverse manipulative information channels (P=.39). Medical credibility could explain the extra variation between technology attractiveness and behavior intention, but not significant under different moderating effect of medical information sources. ©Shan Huei Wang. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.08.2017.

Re-exploration after open heart surgery at the madras medical mission, chennai, India.

Science.gov (United States)

Okonta, Ke; Rajan, S

2011-04-01

Re-explorations after open-heart surgery is a necessity in this Cardiac Center when a patient is obviously bleeding or shows features of cardiovascular instability. Timely intervention may reduce morbidity and mortality. This study aims to correlate the indications with the operative findings for re-explorations after open-heart surgeries as a way of justifying early surgical intervention. Between May2005 and April2011, 10,083 open-heart surgeries were performed in the Adult Cardiac Surgical Unit of the department of cardiac surgery, Institute of Cardiovascular Diseases, Madras Medical Mission, Chennai, India. The demographic data, the initial diagnoses, the types of surgery, the indications for re-exploration, the intraoperative findings, the timing, the estimated blood loss and treatment for the 362 patients who had reexploration were analysed using the Predictive Analysis Soft -ware(PASW)18. Out of the 10,083 patients who had cardiac operation within the period of study, three hundred and sixty two (3.6%) patients had re-exploration shortly after the operation. Males were 311(85.9%) while 51(14.1%) were female patients with mean age of 56.7+12.5years .The mean time interval between the primary surgery and the re-exploratory operation was 2.31+1.47hours and the mean chest tube drainage before re-exploration was 770.9+28.8ml. Coronary Artery Diseases (CAD) was the initial diagnosis 258 (71.3%) patients and Coronary Artery Bypass(CABG) operation was the initial surgery in 254(70.2%)patients, CABG and valve in 12(3.3%)patients, Valve surgery alone in 70(19.3%) patients, Bentall procedure(homograft aortic root replacement)in 13(3.6%) patients, others such as off-pump coronary artery bypass, Dor procedure(patch restoration of left ventricle by incising the aneurysm without excising it), pericardiectomy and thromboembelectomy in 13(3.6%). The indications for re-exploration were post operative haemorrhage in 283(78.2%) patients, Cardiac tamponade in 41(11.3%)patients

Why a Medical Career? "What Makes Sudanese Students to Join a Medical College and Pursue a Medical Career"?

Science.gov (United States)

Mutwali, Ismat Mohammed; Omer, Aisha Ibrahim A.; Abdalhalim, Sadigh Mohammed

2015-01-01

Introduction: Career selection and decision to pursue a medical career is a multi factorial process. It is influenced by the personal capabilities and the available resources as well as the social, educational, economical and cultural factors. Sudan is one of the African countries with a high number of medical colleges and an increasing number of…

Internationalisation of construction business and e-commerce: Innovation, integration and dynamic capabilities

Directory of Open Access Journals (Sweden)

Thayaparan Gajendran

2013-06-01

Full Text Available Despite the role of internet and web based applications in delivering competitive advantage through e-business process is widely acknowledged, little is done by way of research to use the dynamic capability framework, in exploring the role of ecommerce in the construction business internationalisation. The aim of this paper is to present a literature based theoretical exploration using dynamic capability view to discuss internationalising construction businesses through electronic commerce (e-commerce platforms. This paper contextualises the opportunities for internationalising construction, using a mix of supply chain paradigms, embedded with e-commerce platforms. The paper concludes by identifying the potential of dynamic capabilities of a firm, exploiting the innovation and integration potential of different e-business systems, in contributing to the internationalisation of construction businesses. It proposes that contracting firms with developed dynamic capabilities, has the potential to exploit e-commerce platforms to channel upstream activities to an international destination, and also offers the firm’s products/services to international markets.

Capabilities, innovation, and overall performance in Brazilian export firms.

Directory of Open Access Journals (Sweden)

José Ednilson de Oliveira Cabral

2015-06-01

Full Text Available This article extends the current research on innovation by investigating the relationship between innovative capabilities and export firms’ overall performance. From the perspectives of the resource-based view (RBV and dynamic capability, we examine the differential and interactive effects of exploration and exploitation capabilities in product innovation for external markets and overall performance (direct and mediated by a new product. In addition, we test the moderating effect of market dynamism and the controlling effect of firm size on these relationships. Hence, the main contribution of this article is developing and empirically testing an original model, by combining these constructs that address new relationships, in an emerging country. This model was tested with data from 498 Brazilian export firms, distributed throughout all Brazilian manufacturing sectors, by firm size, and in states. The analysis was made with application of the structural equation modeling (SEM. As a result, we found support for the assumptions that exploitation capabilities influence product innovation and overall performance, whereas exploration capabilities and their interaction to exploitation capabilities influence overall performance, but not product innovation. Additionally, the relationship between exploitation capabilities and overall performance is mediated by product innovation. Unlike hypothesized, market dynamism does not moderate the relationship between product innovation and overall performance. Furthermore, firm size works as a controlling variable in the relationships analyzed. Regarding the implications for theory, this study contributes to grasp that exploitation capabilities influences a firm’s overall performance, both directly and indirectly (via product innovation, and highlights the various direct and mediatory effects of innovation on overall performance. These insights show the importance of considering the role of mediating and

THE SISYPHEAN MYTH, NEGATIVE CAPABILITY AND SOCIETAL ...

African Journals Online (AJOL)

mycl

Capability suggest solutions to Camus' Sisyphean problem and its ilk. This paper explores this ... Framed us in jest, and left us now to hazardry? ... and right'; this being one half of a saying meant to create value for a soldier's sacrifice of his ... Keats made an interesting observation and propounded the theory of. 'Negative ...

Exploring the Mediation Between KM Infrastructure Capabilities and Organisational Performance: The Penetration of Learning by KM Practices

OpenAIRE

Meng-Lin Shih; Shu-Hui Chuang; Chechen Liao

2009-01-01

Previous studies have examined the relationship between knowledge management (KM) infrastructure capabilities and organisational performance. However, most studies neglect the mediating effect of organisational learning by KM practices (OLKMP) in the relationship between KM infrastructure capabilities and organisational performance. This study uses the survey method to discuss the relationships governing KM infrastructure capabilities, OLKMP and organisational performance. Results of the anal...

Medical Certification System -

Data.gov (United States)

Department of Transportation — Provides automated risk-based decision making capability in support of medical certification and clearances processing associated fees and supporting surveillance of...

Medical Typewriting; Business Education: 7705.32.

Science.gov (United States)

Schull, Amy P.

This guide describes a course designed to prepare students for employment as medical records clerks capable of handling all types of medical forms and reports, and using and spelling medical terminology correctly. The need for medical typists is critical. The guide contains enrollment guidelines, performance objectives (i.e., type medical…

An exploration of contextual dimensions impacting goals of care conversations in postgraduate medical education.

Science.gov (United States)

Roze des Ordons, Amanda L; Lockyer, Jocelyn; Hartwick, Michael; Sarti, Aimee; Ajjawi, Rola

2016-03-21

Postgraduate medical trainees are not well prepared difficult conversations about goals of care with patients and families in the acute care clinical setting. While contextual nuances within the workplace can impact communication, research to date has largely focused on individual communication skills. Our objective was to explore contextual factors that influence conversations between trainees and patients/families about goals of care in the acute care setting. We conducted an exploratory qualitative study involving five focus groups with Internal Medicine trainees (n = 20) and a series of interviews with clinical faculty (n = 11) within a single Canadian centre. Thematic framework analysis was applied to categorize the data and identify themes and subthemes. Challenges and factors enabling goals of care conversations emerged within individual, interpersonal and system dimensions. Challenges included inadequate preparation for these conversations, disconnection between trainees, faculty and patients, policies around documentation, the structure of postgraduate medical education, and resource limitations; these challenges led to missed opportunities, uncertainty and emotional distress. Enabling factors were awareness of the importance of goals of care conversations, support in these discussions, collaboration with colleagues, and educational initiatives enabling skill development; these factors have resulted in learning, appreciation, and an established foundation for future educational initiatives. Contextual factors impact how postgraduate medical trainees communicate with patients/families about goals of care. Attention to individual, interpersonal and system-related factors will be important in designing educational programs that help trainees develop the capacities needed for challenging conversations.

Exploring the effects of telehealth on medical human resources supply: a qualitative case study in remote regions

Directory of Open Access Journals (Sweden)

Duplantie Julie

2007-01-01

Full Text Available Abstract Background The availability of medical human resource supply is a growing concern for rural and remote communities in many countries. In the last decade, various telehealth experiences in Canada have highlighted the potential impact of this technology on professional practice. The purpose of this study was to explore physicians' and managers' perceptions regarding the potential of telehealth to support recruitment and retention of physicians in remote and rural regions. Methods A case study in Eastern Quebec was performed to explore this complex phenomenon. The analytical framework was based on two literature reviews and a Delphi study. Data were collected from semi-structured interviews with 41 physicians and 22 managers. Transcripts were produced and interview content was coded independently by two judges and validated by an expert panel. Results Interviews have highlighted the potential impact of telehealth on several factors influencing the recruitment and retention of physicians in rural and remote regions. The potential effects of telehealth on physicians' choice of practice location could be seen at the professional, organizational, educational and individual levels. For instance, telehealth could improve work satisfaction by allowing a regional on-call duty system and a better follow-up of patients. However, there are also certain limits related to telehealth, such as the fear that it would eventually replace all continuing medical education activities and onsite specialists in remoteregions. Conclusion Telehealth is likely to have an impact on several factors related to medical workforce supply in remote and rural regions. However, the expected benefits will materialize if and only if this technology is properly integrated into organizations as a support to professional practice.

Exploring Rural Disparities in Medical Diagnoses Among Veterans With Transgender-related Diagnoses Utilizing Veterans Health Administration Care.

Science.gov (United States)

Bukowski, Leigh A; Blosnich, John; Shipherd, Jillian C; Kauth, Michael R; Brown, George R; Gordon, Adam J

2017-09-01

Research shows transgender individuals experience pronounced health disparities compared with their nontransgender peers. Yet, there remains insufficient research about health differences within transgender populations. This study seeks to fill this gap by exploring how current urban/rural status is associated with lifetime diagnosis of mood disorder, alcohol dependence disorder, illicit drug abuse disorder, tobacco use, posttraumatic stress disorder, human immunodeficiency virus, and suicidal ideation or attempt among veterans with transgender-related diagnoses. This study used a retrospective review of The Department of Veterans Affairs (VA) administrative data for transgender patients who received VA care from 1997 through 2014. Transgender patients were defined as individuals that had a lifetime diagnosis of any of 4 International Classification of Diseases-9 diagnosis codes associated with transgender status. Independent multivariable logistic regression models were used to explore associations of rural status with medical conditions. Veterans with transgender-related diagnoses residing in small/isolated rural towns had increased odds of tobacco use disorder (adjusted odds ratio=1.39; 95% confidence intervals, 1.09-1.78) and posttraumatic stress disorder (adjusted odds ratio=1.33; 95% confidence intervals, 1.03-1.71) compared with their urban transgender peers. Urban/rural status was not significantly associated with other medical conditions of interest. This study contributes the first empirical investigations of how place of residence is associated with medical diagnoses among veterans with transgender-related diagnoses. The importance of place as a determinant of health is increasingly clear, but for veterans with transgender-related diagnoses this line of research is currently limited. The addition of self-reported sex identity data within VA electronic health records is one way to advance this line of research.

Desert Rats 2011 Mission Simulation: Effects of Microgravity Operational Modes on Fields Geology Capabilities

Science.gov (United States)

Bleacher, Jacob E.; Hurtado, J. M., Jr.; Meyer, J. A.

2012-01-01

Desert Research and Technology Studies (DRATS) is a multi-year series of NASA tests that deploy planetary surface hardware and exercise mission and science operations in difficult conditions to advance human and robotic exploration capabilities. DRATS 2011 (Aug. 30-Sept. 9, 2011) tested strategies for human exploration of microgravity targets such as near-Earth asteroids (NEAs). Here we report the crew perspective on the impact of simulated microgravity operations on our capability to conduct field geology.

Behaviour of medical students in seeking mental and physical health care: exploration and comparison with psychology students.

Science.gov (United States)

Brimstone, Renee; Thistlethwaite, Jill E; Quirk, Frances

2007-01-01

Doctors are often reluctant to seek health care through the usual channels and tend to self-diagnose and prescribe. Medical students learn attitudes and values from clinician role models and may also adopt behaviour patterns that lead them to seek help for physical and mental health problems from informal sources. This study aimed to explore the behaviour of students in seeking health care for physical and mental health problems, comparing medical with psychology students, and to understand what barriers to conventional routes of seeking health care may affect this. We administered a questionnaire asking for demographic details and responses to 2 vignettes in which a student from the respondent's discipline was experiencing firstly symptoms of a mental health problem and secondly symptoms of a physical health problem. Data were analysed with spss and univariate anovas to examine differences between respondents. A total of 172 students at the psychology and medical schools at James Cook University in Australia participated. We identified a number of barriers affecting student behaviour in seeking help, which included worries about knowing the doctor they could consult at the university health centre or having future dealings with him or her, and cost of treatment. There were differences between the 2 groups of students. There are several barriers for both psychology and medical students to accessing appropriate professional mental health care. Medical students also experience barriers to attaining appropriate physical health care when needed. Psychology and medical students were more likely to seek advice informally from friends and/or family with regard to mental health care.

Nurses Exploring the Spirituality of Their Patients With Cancer: Participant Observation on a Medical Oncology Ward.

Science.gov (United States)

van Meurs, Jacqueline; Smeets, Wim; Vissers, Kris C P; Groot, Marieke; Engels, Yvonne

2017-07-19

Attention for spirituality should be an integral part of professionals' caregiving. Particularly, nurses caring for patients with cancer might have opportunities to give attention to this dimension. The aim of this study was to gain insight in the way and extent to which nurses during daily caregiving observe and explore spiritual issues of hospitalized patients with cancer. We performed an ethnographic study with participant observation. Data were collected in 2015 during 4 shifts at the medical oncology department of a university hospital. The researcher, a spiritual care provider (chaplain) wearing the same kind of uniform as the nurses, observed the nurses, participated in their actions, and interviewed them after the shift. Although the patients did send many implicit and explicit messages concerning spiritual issues, the nurses did not explore them. If noticed, 3 barriers for exploring spiritual issues were mentioned by the nurses: lack of time, conflict with their mindset, and being reserved to talk about such issues. During their daily caregiving to patients with a life-threatening illness, nurses have many opportunities to explore spiritual issues, but they do not often recognize them. If they do, they tend not to explore the spiritual issues. Communication training for nurses is necessary to develop skills for exploring the spiritual dimension in patients with cancer. In such training, attention to the misconception that such a conversation requires a lot of time and for recognizing signals from patients inviting an exploration of their concerns is necessary.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

The Integrated Medical Model - Optimizing In-flight Space Medical Systems to Reduce Crew Health Risk and Mission Impacts

Science.gov (United States)

Kerstman, Eric; Walton, Marlei; Minard, Charles; Saile, Lynn; Myers, Jerry; Butler, Doug; Lyengar, Sriram; Fitts, Mary; Johnson-Throop, Kathy

2009-01-01

The Integrated Medical Model (IMM) is a decision support tool used by medical system planners and designers as they prepare for exploration planning activities of the Constellation program (CxP). IMM provides an evidence-based approach to help optimize the allocation of in-flight medical resources for a specified level of risk within spacecraft operational constraints. Eighty medical conditions and associated resources are represented in IMM. Nine conditions are due to Space Adaptation Syndrome. The IMM helps answer fundamental medical mission planning questions such as What medical conditions can be expected? What type and quantity of medical resources are most likely to be used?", and "What is the probability of crew death or evacuation due to medical events?" For a specified mission and crew profile, the IMM effectively characterizes the sequence of events that could potentially occur should a medical condition happen. The mathematical relationships among mission and crew attributes, medical conditions and incidence data, in-flight medical resources, potential clinical and crew health end states are established to generate end state probabilities. A Monte Carlo computational method is used to determine the probable outcomes and requires up to 25,000 mission trials to reach convergence. For each mission trial, the pharmaceuticals and supplies required to diagnose and treat prevalent medical conditions are tracked and decremented. The uncertainty of patient response to treatment is bounded via a best-case, worst-case, untreated case algorithm. A Crew Health Index (CHI) metric, developed to account for functional impairment due to a medical condition, provides a quantified measure of risk and enables risk comparisons across mission scenarios. The use of historical in-flight medical data, terrestrial surrogate data as appropriate, and space medicine subject matter expertise has enabled the development of a probabilistic, stochastic decision support tool capable of

Enacting Pedagogy in Curricula: On the Vital Role of Governance in Medical Education.

Science.gov (United States)

Casiro, Oscar; Regehr, Glenn

2018-02-01

Managing curricula and curricular change involves both a complex set of decisions and effective enactment of those decisions. The means by which decisions are made, implemented, and monitored constitute the governance of a program. Thus, effective academic governance is critical to effective curriculum delivery. Medical educators and medical education researchers have been invested heavily in issues of educational content, pedagogy, and design. However, relatively little consideration has been paid to the governance processes that ensure fidelity of implementation and ongoing refinements that will bring curricular practices increasingly in line with the pedagogical intent. In this article, the authors reflect on the importance of governance in medical schools and argue that, in an age of rapid advances in knowledge and medical practices, educational renewal will be inhibited if discussions of content and pedagogy are not complemented by consideration of a governance framework capable of enabling change. They explore the unique properties of medical curricula that complicate academic governance, review the definition and properties of good governance, offer mechanisms to evaluate the extent to which governance is operating effectively within a medical program, and put forward a potential research agenda for increasing the collective understanding of effective governance in medical education.

Compact Neutron Generators for Medical Home Land Security and Planetary Exploration

International Nuclear Information System (INIS)

Reijonen, J.

2005-01-01

The Plasma and Ion Source Technology Group at Lawrence Berkeley National Laboratory has developed various types of advanced D-D (neutron energy 2.5 MeV), D-T (14 MeV) and T-T (0-9 MeV) neutron generators for wide range of applications. These applications include medical (Boron Neutron Capture Therapy), homeland security (Prompt Gamma Activation Analysis, Fast Neutron Activation Analysis and Pulsed Fast Neutron Transmission Spectroscopy) and planetary exploration with a sub-surface material characterization on Mars. These neutron generators utilize RF induction discharge to ionize the deuterium/tritium gas. This discharge method provides high plasma density for high output current, high atomic species from molecular gases, long life operation and versatility for various discharge chamber geometries. Four main neutron generator developments are discussed here: high neutron output co-axial neutron generator for BNCT applications, point neutron generator for security applications, compact and sub-compact axial neutron generator for elemental analysis applications. Current status of the neutron generator development with experimental data will be presented

Information architecture for a planetary 'exploration web'

Science.gov (United States)

Lamarra, N.; McVittie, T.

2002-01-01

'Web services' is a common way of deploying distributed applications whose software components and data sources may be in different locations, formats, languages, etc. Although such collaboration is not utilized significantly in planetary exploration, we believe there is significant benefit in developing an architecture in which missions could leverage each others capabilities. We believe that an incremental deployment of such an architecture could significantly contribute to the evolution of increasingly capable, efficient, and even autonomous remote exploration.

Performance Support Tools for Space Medical Operations

Science.gov (United States)

Byrne, Vicky E.; Schmidt, Josef; Barshi, Immanuel

2009-01-01

The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to ISS, medical equipment will be located on ISS, and carried into CEV in the event of an emergency. Flight Surgeons (FS) on the ground in Mission Control will be expected to direct the Crew Medical Officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. Human factors personnel at Johnson Space Center have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground. This area of research involved the feasibility of Just-in-time (JIT) training techniques and concepts for real-time medical procedures. In Phase 1, preliminary feasibility data was gathered for two types of prototype display technologies: a hand-held PDA, and a Head Mounted Display (HMD). The PDA and HMD were compared while performing a simulated medical procedure using ISS flight-like medical equipment. Based on the outcome of Phase 1, including data on user preferences, further testing was completed using the PDA only. Phase 2 explored a wrist-mounted PDA, and compared it to a paper cue card. For each phase, time to complete procedures, errors, and user satisfaction were captured. Information needed by the FS during ISS mission support, especially for an emergency situation (e.g. fire onboard ISS), may be located in many different places around the FS s console. A performance support tool prototype is being developed to address this issue by bringing all of the relevant information together in one place. The tool is designed to include procedures and other information needed by a FS

Capability through Participatory Democracy: Sen, Freire, and Dewey

Science.gov (United States)

Glassman, Michael; Patton, Rikki

2014-01-01

This paper explores possible important relationships and sympathies between Amartya Sen's Capabilities Approach framework for understanding the human condition and the educational ideas of John Dewey and Paolo Freire. All three focus on the importance of democratic values in a fair, well-functioning society, while Sen and Freire especially…

Designing Technology: An Exploration of the Relationship between Technological Literacy and Design Capability

Science.gov (United States)

Hope, Gill

2013-01-01

The aim of this article is to contribute to the debate on the nature of technology education. This is especially pertinent at times of curriculum change and uncertainty, such as currently exist in relation to the Primary school curriculum in England and Wales. Two phrases ("technological literacy" and "design capability") have…

Pediatric Nurses' Perceptions of Medication Safety and Medication Error: A Mixed Methods Study.

Science.gov (United States)

Alomari, Albara; Wilson, Val; Solman, Annette; Bajorek, Beata; Tinsley, Patricia

2017-05-30

This study aims to outline the current workplace culture of medication practice in a pediatric medical ward. The objective is to explore the perceptions of nurses in a pediatric clinical setting as to why medication administration errors occur. As nurses have a central role in the medication process, it is essential to explore nurses' perceptions of the factors influencing the medication process. Without this understanding, it is difficult to develop effective prevention strategies aimed at reducing medication administration errors. Previous studies were limited to exploring a single and specific aspect of medication safety. The methods used in these studies were limited to survey designs which may lead to incomplete or inadequate information being provided. This study is phase 1 on an action research project. Data collection included a direct observation of nurses during medication preparation and administration, audit based on the medication policy, and guidelines and focus groups with nursing staff. A thematic analysis was undertaken by each author independently to analyze the observation notes and focus group transcripts. Simple descriptive statistics were used to analyze the audit data. The study was conducted in a specialized pediatric medical ward. Four key themes were identified from the combined quantitative and qualitative data: (1) understanding medication errors, (2) the busy-ness of nurses, (3) the physical environment, and (4) compliance with medication policy and practice guidelines. Workload, frequent interruptions to process, poor physical environment design, lack of preparation space, and impractical medication policies are identified as barriers to safe medication practice. Overcoming these barriers requires organizations to review medication process policies and engage nurses more in medication safety research and in designing clinical guidelines for their own practice.

Structural Capability of an Organization toward Innovation Capability

DEFF Research Database (Denmark)

Nielsen, Susanne Balslev; Momeni, Mostafa

2016-01-01

The scholars in the field of strategic management have developed two major approaches for attainment of competitive advantage: an approach based on environmental opportunities, and another one based on internal capabilities of an organization. Some investigations in the last two decades have...... indicated that the advantages relying on the internal capabilities of organizations may determine the competitive position of organizations better than environmental opportunities do. Characteristics of firms shows that one of the most internal capabilities that lead the organizations to the strongest...... competitive advantage in the organizations is the innovation capability. The innovation capability is associated with other organizational capabilities, and many organizations have focused on the need to identify innovation capabilities.This research focuses on recognition of the structural aspect...

Does organizational agility affect organizational learning capability? Evidence from commercial banking

OpenAIRE

Zaina Mustafa Mahmoud Hamad; Uğur Yozgat

2017-01-01

Both organizational agility and learning capability are prerequisites for organizational survival and success. This study explores the contribution of agility practices to organizational learning capabilities at the commercial banks in Jordan. To examine the proposed model, a sample of 158 employees within top and middle managements was used. Structural Equation Modeling was conducted for assessing validity and reliability of measurement instrument, evaluating model fit, and testing hypothese...

Deployment of vendor innovation capability in contract electronic manufacturing

DEFF Research Database (Denmark)

Perunovic, Zoran; Mefford, Robert N.

2012-01-01

This paper explores deployment of innovation capability in outsourcing from the vendor perspective. Vendor’s innovation-related competences are used to capture vendor innovativeness. A multiple-case study was applied with two Contract Electronic Manufacturers. Based on the data analysis we propose...

Practice Report / Bericht aus der Praxis: An exploration of peer tutor roles and recruitment at German medical schools.

Science.gov (United States)

Alvarez, Simone; Schultz, Jobst-Hendrik

2017-11-01

Almost all medical faculties in Germany actively employ peer tutors. However, little is known about the roles these tutors play from a faculty point of view. Also, there are only few descriptions of the tutor recruitment and selection processes. 32 of the medical faculties in Germany, where tutors are used in the training of medical students, were asked to provide information on the role and recruitment of tutors by means of a partially standardized questionnaire. At the surveyed faculties (return rate 28%), tutors are mostly employed for the purpose of teaching staff support. Even though desired in individual cases, tutors rarely play an active role in curriculum- or faculty development. The way tutor recruitment is handled strongly depends on the capabilities of the individual faculties and the way tutors are utilized. In many cases this process is structured, consisting of written and oral application phases, in other cases recruitment takes place without formal application procedures. The selection criteria, however, were found to be very similar at most faculties. The role of tutors from the faculties' point of view depends strongly on the respective nature of the tutorials, which are just as diverse as the approaches to tutor recruitment. Copyright © 2017. Published by Elsevier GmbH.

Capabilities for Living and Lifelong Learning: What's Science Got to Do with It?

Science.gov (United States)

Bull, Ally

2015-01-01

Science capabilities are a set of ideas for teachers to think with about science education. There are five: gathering and interpreting data, using evidence, critiquing evidence, interpreting representations of science, and engaging with science. This paper explores what student progress in developing capabilities might look like. It draws on…

A triple helix model of medical innovation: Supply, demand, and technological capabilities in terms of Medical Subject Headings

NARCIS (Netherlands)

Petersen, A.M.; Rotolo, D.; Leydesdorff, L.

We develop a model of innovation that enables us to trace the interplay among three key dimensions of the innovation process: (i) demand of and (ii) supply for innovation, and (iii) technological capabilities available to generate innovation in the forms of products, processes, and services.

National power grid simulation capability : need and issues

Energy Technology Data Exchange (ETDEWEB)

Petri, Mark C. [Argonne National Lab. (ANL), Argonne, IL (United States)

2009-06-02

On December 9 and 10, 2008, the Department of Homeland Security (DHS) Science and Technology Directorate sponsored a national workshop at Argonne National Laboratory to explore the need for a comprehensive modeling and simulation capability for the national electric power grid system. The workshop brought together leading electric power grid experts from federal agencies, the national laboratories, and academia to discuss the current state of power grid science and engineering and to assess if important challenges are being met. The workshop helped delineate gaps between grid needs and current capabilities and identify issues that must be addressed if a solution is to be implemented. This report is a result of the workshop and highlights power grid modeling and simulation needs, the barriers that must be overcome to address them, and the benefits of a national power grid simulation capability.

Dynamic capabilities and network benefits

Directory of Open Access Journals (Sweden)

Helge Svare

2017-01-01

Full Text Available The number of publicly funded initiatives to establish or strengthen networks and clusters, in order to enhance innovation, has been increasing. Returns on such investments vary, and the aim of this study is to explore to what extent the variation in benefits for firms participating in networks or clusters can be explained by their dynamic capabilities (DC. Based on survey data from five Norwegian networks, the results suggest that firms with higher DC are more successful in harvesting the potential benefits of being member of a network.

Explore the Capability of ESPAR Antennas for Low Cost Communication

DEFF Research Database (Denmark)

Han, Bo; Kalis, A; Papadias, C.

ESPAR antenna systems are composed of one active and several parasitic elements and by changing the characteristic of the parasitic elements on the antenna, the radiation pattern will also change. Such characteristic makes ESPAR antenna useful in many applications, e.g., single RF MIMO transmission...... and imaginary part. So a matching network is required to control the load value. This paper presents an idea of adjusting the parasitic ESPAR antenna loads with controllable passive elements. According to simulation, the control circuit consumes less than 1mW power on 64 patterns selection, which explores...

A Revolution in the Making: Advances in Materials That May Transform Future Exploration Infrastructures and Missions

Science.gov (United States)

Harris, Charles E.; Dicus, Dennis L.; Shuart, Mark J.

2001-01-01

The NASA Strategic Plan identifies the long-term goal to provide safe and affordable space access, orbital transfer, and interplanetary transportation capabilities to enable research, human exploration, and the commercial development of space; and to conduct human and robotic missions to planets and other bodies in our solar system. Numerous scientific and engineering breakthroughs will be required to develop the technology necessary to achieve this goal. Critical technologies include advanced vehicle primary and secondary structure, radiation protection, propulsion and power systems, fuel storage, electronics and devices, sensors and science instruments, and medical diagnostics and treatment. Advanced materials with revolutionary new capabilities are an essential element of each of these technologies. This paper discusses those materials best suited for aerospace vehicle structure and highlights the enormous potential of one revolutionary new material, carbon nanotubes.

Exploration of Global Health Careers Across the Medical Fields.

Science.gov (United States)

Barthélemy, Ernest; Mallol, Vanessa; Hannaford, Alisse; Pean, Christian; Kutua, Rehema; de Haydu, Christopher; Anandaraja, Natasha; Asgary, Ramin; Elahi, Ebrahim; Hexom, Braden; Landrigan, Philip; Shirazian, Taraneh; Katz, Craig

Despite expansion of interest among American medical students in global health (GH), academic medical centers face multiple obstacles to the development of structured GH curricula and career guidance. To meet these demands we sought to provide a systematic analysis of the accounts of GH experts. We developed a collaborative, interview-based, qualitative analysis of GH experiences across six career-related themes that are relevant to medical students interested in GH: justification, medical education, economics, research prospects, law and ethics, and work-life balance. Seven GH faculty members were interviewed for 30-90 minutes using sample questions as guidelines. We applied a grounded theory approach to analyze the interview transcripts to discover an emerging theory pertinent to GH trainees. Regarding justification, 4 respondents defined GH as work with the underserved irrespective of geographic location; 5 respondents found sustainability imperative; and all respondents believe GH creates better physicians. Respondents identified many physician competencies developed through GH medical education, with 5 respondents agreeing that work with underserved populations has transformative potential. Concerning economics, 3 respondents acknowledged GH's popularity among trainees, resulting in increased training opportunities, and 2 respondents emphasized an associated deficiency in program quality. All respondents described career models across specialties. Four respondents noted funding challenges when discussing research prospects. Within the theme of laws and ethics, 4 respondents perceived inadequate accountability, and 6 respondents identified ways to create accountability. Finally, 6 respondents recognized family demands can compromise one's GH career and thus work-life balance. Despite diverse perspectives on the meaning and sustainability of GH work, this analysis provides a nascent framework that may inform curricular development for GH trainees. Suggestions

Exploration Health Risks: Probabilistic Risk Assessment

Science.gov (United States)

Rhatigan, Jennifer; Charles, John; Hayes, Judith; Wren, Kiley

2006-01-01

Maintenance of human health on long-duration exploration missions is a primary challenge to mission designers. Indeed, human health risks are currently the largest risk contributors to the risks of evacuation or loss of the crew on long-duration International Space Station missions. We describe a quantitative assessment of the relative probabilities of occurrence of the individual risks to human safety and efficiency during space flight to augment qualitative assessments used in this field to date. Quantitative probabilistic risk assessments will allow program managers to focus resources on those human health risks most likely to occur with undesirable consequences. Truly quantitative assessments are common, even expected, in the engineering and actuarial spheres, but that capability is just emerging in some arenas of life sciences research, such as identifying and minimize the hazards to astronauts during future space exploration missions. Our expectation is that these results can be used to inform NASA mission design trade studies in the near future with the objective of preventing the higher among the human health risks. We identify and discuss statistical techniques to provide this risk quantification based on relevant sets of astronaut biomedical data from short and long duration space flights as well as relevant analog populations. We outline critical assumptions made in the calculations and discuss the rationale for these. Our efforts to date have focussed on quantifying the probabilities of medical risks that are qualitatively perceived as relatively high risks of radiation sickness, cardiac dysrhythmias, medically significant renal stone formation due to increased calcium mobilization, decompression sickness as a result of EVA (extravehicular activity), and bone fracture due to loss of bone mineral density. We present these quantitative probabilities in order-of-magnitude comparison format so that relative risk can be gauged. We address the effects of

Exploration: A misunderstood business

International Nuclear Information System (INIS)

Lohrenz, J.

1991-01-01

The business of exploration is persistently misunderstand. Why? Misunderstandings persist and even pervade educated, sophisticated, and obviously capable business practitioners and savants of an array of disciplines - finance, economics, and the management sciences. Routine and appropriate assumptions that apply for most businesses invoke nonsense applied to exploration, a unique business. The uniqueness of exploration, unrecognized, sustains the misunderstandings. The authors will not here obliterate these obdurate misunderstandings with some revelation. They show, however, how the misunderstandings naturally arise among those who certainly are not used to being naive

Establishing a Research and Evaluation Capability for the Joint Medical Education and Training Campus

OpenAIRE

Kirby, Sheila Nataraj; Marsh, Julie A.; Thie, Harry J.

2011-01-01

In calling for the transformation of military medical education and training, the 2005 Base Realignment and Closure Commission recommended relocating basic and specialty enlisted medical training to a single site to take advantage of economies of scale and the opportunity for joint training. As a result, a joint medical education and training campus (METC) has been established at Fort Sam Houston, Texas. Two of METC's primary long-term goals are to become a high-performing learning organizati...

Exploring Perception and Use of Everyday Language and Medical Terminology among International Medical Graduates in a Medical ESP Course in Australia

Science.gov (United States)

Dahm, Maria R.

2011-01-01

Language and communication skills are among the greatest challenges that non-native-English speaking international medical graduates (IMGs) face in English medical consultations. Especially when patients use unfamiliar everyday expressions or attach different meanings to medical terminology, the communicative burden on doctor-patient communication…

Exploring Canadian Physicians' Experiences Providing Medical Assistance in Dying: A Qualitative Study.

Science.gov (United States)

Khoshnood, Narges; Hopwood, Marie-Clare; Lokuge, Bhadra; Kurahashi, Allison; Tobin, Anastasia; Isenberg, Sarina; Husain, Amna

2018-05-15

MAiD allows a practitioner to administer or prescribe medication for the purpose of ending a patient's life. In 2016, Canada was the latest country, following several European countries and American states, to legalize physician-assisted death. Although some studies report on physician attitudes towards MAiD or describe patient characteristics, there are few that explore the professional challenges faced by physicians who provide MAiD. To explore the professional challenges faced by Canadian physicians who provide MAiD. Sixteen physicians from across Canada who provide MAiD completed in-depth, semi-structured telephone interviews. An inductive thematic analysis approach guided data collection and the iterative, interpretive analysis of interview transcripts. Three members of the research team systematically co-coded interview transcripts and the emerging themes were developed with the broader research team. NVivo was used to manage the coded data. Participants described three challenges associated with providing MAiD: 1) their relationships with other MAiD providers were enhanced and relationships with objecting colleagues were sometimes strained, 2) they received inadequate financial compensation for time, and, 3) they experienced increased workload, resulting in sacrifices to personal time. Although these providers did not intend to stop providing MAiD at the time of the interview, they indicated their concerns about whether they would be able to sustain this service over time. Physicians described relationship, financial, and workload challenges to providing MAiD. We provide several recommendations to address these challenges and help ensure the sustainability of MAiD in countries that provide this service. Copyright © 2018. Published by Elsevier Inc.

Cannabinoids: Medical implications.

Science.gov (United States)

Schrot, Richard J; Hubbard, John R

2016-01-01

Herbal cannabis has been used for thousands of years for medical purposes. With elucidation of the chemical structures of tetrahydrocannabinol (THC) and cannabidiol (CBD) and with discovery of the human endocannabinoid system, the medical usefulness of cannabinoids has been more intensively explored. While more randomized clinical trials are needed for some medical conditions, other medical disorders, like chronic cancer and neuropathic pain and certain symptoms of multiple sclerosis, have substantial evidence supporting cannabinoid efficacy. While herbal cannabis has not met rigorous FDA standards for medical approval, specific well-characterized cannabinoids have met those standards. Where medical cannabis is legal, patients typically see a physician who "certifies" that a benefit may result. Physicians must consider important patient selection criteria such as failure of standard medical treatment for a debilitating medical disorder. Medical cannabis patients must be informed about potential adverse effects, such as acute impairment of memory, coordination and judgment, and possible chronic effects, such as cannabis use disorder, cognitive impairment, and chronic bronchitis. In addition, social dysfunction may result at work/school, and there is increased possibility of motor vehicle accidents. Novel ways to manipulate the endocannbinoid system are being explored to maximize benefits of cannabinoid therapy and lessen possible harmful effects.

Socialization, Indifference, and Convenience: Exploring the Uptake of Influenza Vaccine Among Medical Students and Early Career Doctors.

Science.gov (United States)

Edge, Rhiannon; Goodwin, Dawn; Isba, Rachel; Keegan, Thomas

2017-11-01

The Chief Medical Officer recommends that all health care workers receive an influenza vaccination annually. High vaccination coverage is believed to be the best protection against the spread of influenza within a hospital, although uptake by health care workers remains low. We conducted semistructured interviews with seven medical students and nine early career doctors, to explore the factors informing their influenza vaccination decision making. Data collection and analysis took place iteratively, until theoretical saturation was achieved, and a thematic analysis was performed. Socialization was important although its effects were attenuated by participants' previous experiences and a lack of clarity around the risks and benefits of vaccination. Many participants did not have strong intentions regarding vaccination. There was considerable disparity between an individual's opinion of the vaccine, their intentions, and their vaccination status. The indifference demonstrated here suggests few are strongly opposed to the vaccination-there is potential to increase vaccination coverage.

General practitioners' perceptions of the effectiveness of medical interventions: an exploration of underlying constructs

Directory of Open Access Journals (Sweden)

Marteau Theresa M

2010-02-01

Full Text Available Abstract Background Many interventions shown to be effective through clinical trials are not readily implemented in clinical practice. Unfortunately, little is known regarding how clinicians construct their perceptions of the effectiveness of medical interventions. This study aims to explore general practitioners' perceptions of the nature of 'effectiveness'. Methods The design was qualitative in nature using the repertory grid technique to elicit the constructs underlying the perceived effectiveness of a range of medical interventions. Eight medical interventions were used as stimuli (diclophenac to reduce acute pain, cognitive behaviour therapy to treat depression, weight loss surgery to achieve weight loss, diet and exercise to prevent type 2 diabetes, statins to prevent heart disease, stopping smoking to prevent heart disease, nicotine replacement therapy to stop smoking, and stop smoking groups to stop smoking. The setting involved face-to-face interviews followed by questionnaires in London Primary Care Trusts. Participants included a random sample of 13 general practitioners. Results Analysis of the ratings showed that the constructs clustered around two dimensions: low patient effort versus high patient effort (dimension one, and small impact versus large impact (dimension two. Dimension one represented constructs such as 'success requires little motivation', 'not a lifestyle intervention', and 'health-care professional led intervention'. Dimension two represented constructs such as 'weak and/or minimal evidence of effectiveness', 'small treatment effect for users', 'a small proportion of users will benefit' and 'not cost-effective'. Constructs within each dimension were closely related. Conclusions General practitioners judged the effectiveness of medical interventions by considering two broad dimensions: the extent to which interventions involve patient effort, and the size of their impact. The latter is informed by trial evidence, but

The development of capability measures in health economics: opportunities, challenges and progress.

Science.gov (United States)

Coast, Joanna; Kinghorn, Philip; Mitchell, Paul

2015-04-01

Recent years have seen increased engagement amongst health economists with the capability approach developed by Amartya Sen and others. This paper focuses on the capability approach in relation to the evaluative space used for analysis within health economics. It considers the opportunities that the capability approach offers in extending this space, but also the methodological challenges associated with moving from the theoretical concepts to practical empirical applications. The paper then examines three 'families' of measures, Oxford Capability instruments (OxCap), Adult Social Care Outcome Toolkit (ASCOT) and ICEpop CAPability (ICECAP), in terms of the methodological choices made in each case. The paper concludes by discussing some of the broader issues involved in making use of the capability approach in health economics. It also suggests that continued exploration of the impact of different methodological choices will be important in moving forward.

Improving global laboratory capabilities for emergency radionuclide bioassay

International Nuclear Information System (INIS)

Li, C.; Jourdain, J.; Kramer, G. H.

2012-01-01

During a radiological or nuclear emergency, first-responders and the general public may be internally contaminated with the radionuclide(s) involved. A timely radionuclide bioassay provides important information about contamination, for subsequent dose assessment and medical management. Both technical and operational gaps are discussed in this paper. As many people may need to be assessed in a short period of time, any single laboratory may find its capabilities insufficient. Laboratories from other regions or other countries may be called upon for assistance. This paper proposes a road-map to improve global capabilities in emergency radionuclide bioassay, suggesting a phased approach for establishing a global laboratory network. Existing international collaboration platforms could provide the base on which to build such a network. (authors)

Development of a gamma ray spectroscopy capability at LANSCE

International Nuclear Information System (INIS)

Nelson, R.O.; Strottman, D.D.; Sterbenz, S.M.

1998-01-01

This is the final report of a one-year, Laboratory Directed Research and Development (LDRD) project at the Los Alamos National Laboratory (LANL). The goal of this project was to explore an upgrade to the GEANIE high-resolution gamma-ray spectrometer at the Los Alamos Neutron Science Center (LANSCE) to help build additional experimental capabilities. The improvements identified have significantly added to the capabilities of GEANIE and made the facility more attractive for studies supporting the core national security mission as well as for use by outside collaborators. These benefits apply to both basic and applied studies

Uranium exploration in Ecuador

International Nuclear Information System (INIS)

Severne, B.; Penaherrera, P.F.; Fiallos, V.S.

1981-01-01

The 600-km segment of the Andean Cordillera in Ecuador includes zones that can be correlated, geologically, with uranium districts elsewhere in the Andes. It is believed that these essentially unexplored zones have the potential for economic uranium mineralization. Exploration activity to date has been limited, although it has involved both geochemical and radiometric techniques to evaluate geological concepts. Minor uranium occurrences (with chemical analyses up to 100 ppm) have been encountered, which provide further incentive to commence large-scale systematic exploration. It is recognized that a very large exploration budget and considerable technical expertise will be required to ensure exploration success. Consequently, participation by groups of proven capability from other countries will be sought for Ecuador's national exploration programme. (author)

Integrated Medical Model Project - Overview and Summary of Historical Application

Science.gov (United States)

Myers, J.; Boley, L.; Butler, D.; Foy, M.; Goodenow, D.; Griffin, D.; Keenan, A.; Kerstman, E.; Melton, S.; McGuire, K.;

From Particle Physics to Medical Applications

Science.gov (United States)

Dosanjh, Manjit

2017-06-01

CERN is the world's largest particle physics research laboratory. Since it was established in 1954, it has made an outstanding contribution to our understanding of the fundamental particles and their interactions, and also to the technologies needed to analyse their properties and behaviour. The experimental challenges have pushed the performance of particle accelerators and detectors to the limits of our technical capabilities, and these groundbreaking technologies can also have a significant impact in applications beyond particle physics. In particular, the detectors developed for particle physics have led to improved techniques for medical imaging, while accelerator technologies lie at the heart of the irradiation methods that are widely used for treating cancer. Indeed, many important diagnostic and therapeutic techniques used by healthcare professionals are based either on basic physics principles or the technologies developed to carry out physics research. Ever since the discovery of x-rays by Roentgen in 1895, physics has been instrumental in the development of technologies in the biomedical domain, including the use of ionizing radiation for medical imaging and therapy. Some key examples that are explored in detail in this book include scanners based on positron emission tomography, as well as radiation therapy for cancer treatment. Even the collaborative model of particle physics is proving to be effective in catalysing multidisciplinary research for medical applications, ensuring that pioneering physics research is exploited for the benefit of all.

Exploring emerging learning needs: a UK-wide consultation on environmental sustainability learning objectives for medical education.

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Walpole, Sarah C; Mortimer, Frances; Inman, Alice; Braithwaite, Isobel; Thompson, Trevor

2015-12-24

This study aimed to engage wide-ranging stakeholders and develop consensus learning objectives for undergraduate and postgraduate medical education. A UK-wide consultation garnered opinions of healthcare students, healthcare educators and other key stakeholders about environmental sustainability in medical education. The policy Delphi approach informed this study. Draft learning objectives were revised iteratively during three rounds of consultation: online questionnaire or telephone interview, face-to-face seminar and email consultation. Twelve draft learning objectives were developed based on review of relevant literature. In round one, 64 participants' median ratings of the learning objectives were 3.5 for relevance and 3.0 for feasibility on a Likert scale of one to four. Revisions were proposed, e.g. to highlight relevance to public health and professionalism. Thirty three participants attended round two. Conflicting opinions were explored. Added content areas included health benefits of sustainable behaviours. To enhance usability, restructuring provided three overarching learning objectives, each with subsidiary points. All participants from rounds one and two were contacted in round three, and no further edits were required. This is the first attempt to define consensus learning objectives for medical students about environmental sustainability. Allowing a wide range of stakeholders to comment on multiple iterations of the document stimulated their engagement with the issues raised and ownership of the resulting learning objectives.

Do Village Girls Gain Empowering Capabilities through Schooling and What Functionings Do They Value?

Science.gov (United States)

Seeberg, Vilma; Luo, Shujuan

2012-01-01

This paper explores the relationship between girls' schooling and empowerment in western China in the first decade of the 21st century. This paper adopted a capability-empowerment framework based on Sen's capability approach into which were integrated concepts by Bourdieu, Appadurai, Nussbaum, Kabeer, and Unterhalter, to help to understand the…

General practitioners' decisions about discontinuation of medication: an explorative study.

Science.gov (United States)

Nixon, Michael Simon; Vendelø, Morten Thanning

2016-06-20

Purpose - The purpose of this paper is to investigate how general practitioners' (GPs) decisions about discontinuation of medication are influenced by their institutional context. Design/methodology/approach - In total, 24 GPs were interviewed, three practices were observed and documents were collected. The Gioia methodology was used to analyse data, drawing on a theoretical framework that integrate the sensemaking perspective and institutional theory. Findings - Most GPs, who actively consider discontinuation, are reluctant to discontinue medication, because the safest course of action for GPs is to continue prescriptions, rather than discontinue them. The authors conclude that this is in part due to the ambiguity about the appropriateness of discontinuing medication, experienced by the GPs, and in part because the clinical guidelines do not encourage discontinuation of medication, as they offer GPs a weak frame for discontinuation. Three reasons for this are identified: the guidelines provide dominating triggers for prescribing, they provide weak priming for discontinuation as an option, and they underscore a cognitive constraint against discontinuation. Originality/value - The analysis offers new insights about decision making when discontinuing medication. It also offers one of the first examinations of how the institutional context embedding GPs influences their decisions about discontinuation. For policymakers interested in the discontinuation of medication, the findings suggest that de-stigmatising discontinuation on an institutional level may be beneficial, allowing GPs to better justify discontinuation in light of the ambiguity they experience.

Exploring the use of smartphones and tablets by medical House ...

African Journals Online (AJOL)

The Ministry of Health in Ghana has an e-Health strategy, with the aim of integrating such resources into ... into medical practice can be improved by integration with the medical curriculum and accepted practice ..... The likelihood of this being.

Features of commercial computer software systems for medical examiners and coroners.

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Hanzlick, R L; Parrish, R G; Ing, R

1993-12-01

There are many ways of automating medical examiner and coroner offices, one of which is to purchase commercial software products specifically designed for death investigation. We surveyed four companies that offer such products and requested information regarding each company and its hardware, software, operating systems, peripheral devices, applications, networking options, programming language, querying capability, coding systems, prices, customer support, and number and size of offices using the product. Although the four products (CME2, ForenCIS, InQuest, and Medical Examiner's Software System) are similar in many respects and each can be installed on personal computers, there are differences among the products with regard to cost, applications, and the other features. Death investigators interested in office automation should explore these products to determine the usefulness of each in comparison with the others and in comparison with general-purpose, off-the-shelf databases and software adaptable to death investigation needs.

Impact of Personnel Capabilities on Organizational Innovation Capability

DEFF Research Database (Denmark)

Nielsen, Susanne Balslev; Momeni, Mostafa

2016-01-01

in this rapidly changing world. This research focuses on definition of the personnel aspect of innovation capability, and proposes a conceptual model based on the scientific articles of academic literature on organisations innovation capability. This paper includes an expert based validation in three rounds...... of the Delphi method. And for the purpose of a better appreciation of the relationship dominating the factors of the model, it has distributed the questionnaire to Iranian companies in the Food industry. This research proposed a direct relationship between Innovation Capability and the Personnel Capability...

A study on electricity export capability of the μCHP system with spot price

DEFF Research Database (Denmark)

You, Shi; Træholt, Chresten; Poulsen, Bjarne

2009-01-01

of the muCHP unit, which influence the export capability of muCHP system, is firstly carried out in the intraday case study, followed by the annual case study which explores the annual system performance. The results show that the electricity export capability of a muCHP system is closely related to its...

CADMIO: computer aided design for medical information objects.

Science.gov (United States)

Minarelli, D V; Ferri, F; Pisanelli, D M; Ricci, F L; Tittarelli, F

1995-01-01

The growth of the computational capability and the tools of graphic software is nowadays available in an integrated manner into the development environments, thus permitting the realization of tool kits capable of handling information that is complex and of different kinds such as the typical medical information. This has given a great impulse to the creation of electronic medical folders joining together with new and stimulating functionality with respect to the usual paper document [1]. In the present work, we propose a tool capable of defining a multimedia electronic medical folder and representing its architecture through a layout that is formed on the basis of the particular data types to be handled. This tool is capable of providing an integrated view of data that, even though they are close in cognitive sense, are often stored and represented apart in the practice. Different approaches to the browsing feature are giving within the system, thus the user can personalize the way of viewing the information stored into the folder or can let the system guide the browsing.

Response capabilities of the National Guard: a focus on domestic disaster medical response.

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Bochicchio, Daniel

2010-01-01

The National Guard has a 373-year history of responding to the nation's call to duty for service both at home and abroad (The National Guard Bureau Web site: Available at http://www.ngb.army.mil/default. aspx.). The National Guard (NG) is a constitutionally unique organization (United States Constitution, US Government Printing Office Web site: Available at http://www.gpoaccess.gov/constitution/index.html.). Today's Guard conducts domestic disaster response and civilian assistance missions on a daily basis. Yet, the NG's role, mission, and capabilities are not well-known or understood. The National Response Framework (NRF) places significant responsibility on the local and state disaster planners (Department of Homeland Security: National Response Framework. US Department of Homeland Security, Washington, DC, January 2008). The public health professionals are an integral component of the disaster planning community. It is critical that the public health community be knowledgeable of types and capabilities of all the response assets at their disposal.

Exploring the situational motivation of medical specialists: a qualitative study.

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van der Burgt, Stéphanie M E; Kusurkar, Rashmi A; Croiset, Gerda; Peerdeman, Saskia M

2018-02-26

The aim was to obtain insight into the factors in the work environment that motivate or demotivate a medical specialist during his/her working day. A qualitative ethnographic design was used, and a constructivist approach was adopted with the Self-Determination theory of motivation as a framework. Six medical specialists from VU University Medical Center in the Netherlands, recruited through convenience, snowball, and purposive sampling, were shadowed for one day each. Data were transcribed and open-coded. Themes were finalized through discussion and consensus. Sixty hours of observation data identified motivating and demotivating factors categorized into four themes that are important for specialists' motivation. Informational technology issues are demotivating factors. Working with colleagues can be both a motivating and demotivating factor, e.g., filling in for each other through feelings of relatedness was motivating. Being in control of one's planning through feelings of autonomy was motivating. Furthermore, patient care and teaching, especially in combination, stimulated specialists' motivation. Regarding the design of the study, we found that situational motivation is indeed observable. The basic psychological needs autonomy, competence, and relatedness are important for specialists' motivation. Investing in a more motivating, open, transparent, and basic-needs- supportive work environment for medical specialists is necessary. Keywords: Continuing professional development, motivation, medical specialists, self-determination theory, qualitative research.

Archiving Software Systems: Approaches to Preserve Computational Capabilities

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King, T. A.

2014-12-01

A great deal of effort is made to preserve scientific data. Not only because data is knowledge, but it is often costly to acquire and is sometimes collected under unique circumstances. Another part of the science enterprise is the development of software to process and analyze the data. Developed software is also a large investment and worthy of preservation. However, the long term preservation of software presents some challenges. Software often requires a specific technology stack to operate. This can include software, operating systems and hardware dependencies. One past approach to preserve computational capabilities is to maintain ancient hardware long past its typical viability. On an archive horizon of 100 years, this is not feasible. Another approach to preserve computational capabilities is to archive source code. While this can preserve details of the implementation and algorithms, it may not be possible to reproduce the technology stack needed to compile and run the resulting applications. This future forward dilemma has a solution. Technology used to create clouds and process big data can also be used to archive and preserve computational capabilities. We explore how basic hardware, virtual machines, containers and appropriate metadata can be used to preserve computational capabilities and to archive functional software systems. In conjunction with data archives, this provides scientist with both the data and capability to reproduce the processing and analysis used to generate past scientific results.

In-Space Manufacturing (ISM): Pioneering Space Exploration

Science.gov (United States)

Werkheiser, Niki

2015-01-01

ISM Objective: Develop and enable the manufacturing technologies and processes required to provide on-demand, sustainable operations for Exploration Missions. This includes development of the desired capabilities, as well as the required processes for the certification, characterization & verification that will enable these capabilities to become institutionalized via ground-based and ISS demonstrations.

Capability Paternalism

NARCIS (Netherlands)

Claassen, R.J.G.|info:eu-repo/dai/nl/269266224

A capability approach prescribes paternalist government actions to the extent that it requires the promotion of specific functionings, instead of the corresponding capabilities. Capability theorists have argued that their theories do not have much of these paternalist implications, since promoting

A qualitative study to explore communication skills in veterinary medical education.

Science.gov (United States)

Hamood, Wendy J; Chur-Hansen, Anna; McArthur, Michelle L

2014-10-11

To explore and gain an understanding of what "clinical communication skills" mean to veterinarians working in private practice and what implications this might have for veterinary medical education. Qualitative research methods were used to purposefully sample a range of veterinary practitioners from a pool of South Australian veterinary practices who were interviewed to determine their understanding of what communication skills mean in the context of veterinary practice. Interviews were conducted with fourteen veterinary practitioners. Participants were sampled from a range of ages, veterinary schools of graduation plus urban and rural locations. Interview transcripts were analysed for themes, definitions and contexts. Participants' accounts included a number of skills which they considered to be "communication". Some of the definitions of these skills parallel communication skills and competencies for human medicine on which communication skills training incorporated into veterinary curricula to date have largely been based. However, the veterinarians in this study also raised interesting contextual differences unique to the veterinary profession, such as communication with the animal, selling service, discussing money in relation to decisions for care, and communicating about euthanasia. Veterinary practitioners require high level communication skills. Education and training in veterinary medicine may be better tailored to reflect the unique context of the veterinary profession.

Medical Rituals and Media Rituals

OpenAIRE

Zoltán Zsinkó-Szabó

2013-01-01

In the present article the author examines the ritual elements of theprofessionalization during medical studies, and its interference with media content of medical significance, comparing the role of medical and media rituals on the way of becoming a doctor. It is to be explored how these medical soap operas, medical dramas, medical thrillers or crime stories do exert influence on medical identity and role expectations. Do medical students and their relatives (withmedical expertise frequently...

At the precipice: a prospective exploration of medical students' expectations of the pre-clerkship to clerkship transition.

Science.gov (United States)

Soo, Jason; Brett-MacLean, Pamela; Cave, Marie-Therese; Oswald, Anna

2016-03-01

Medical learners face many challenging transitions. We prospectively explored students' perceptions of their upcoming transition to clerkship and their future professional selves. In 2013, 160/165 end-of-second-year medical students wrote narrative reflections and 79/165 completed a questionnaire on their perceptions of their upcoming transition to clerkship. Narratives were separately analyzed by four authors and then discussed to identify a final thematic framework using parsimonious category construction. We identified two overarching themes: (1) "Looking back": experiences which had helped students feel prepared for clerkship with subthemes focused on of patient care, shadowing, classroom teaching and the pre-clerkship years as foundational knowledge, (2) "Looking forward": anticipating the clerkship experience and the journey of becoming a physician with subthemes focused on death and dying, hierarchy, work-life balance, interactions with patients, concerns about competency and career choice. Questionnaire data revealed incongruities around expectations of minimal exposure to death and dying, little need for independent study and limited direct patient responsibility. We confirmed that internal transformations are happening in contemplative time even before clerkship. By prospectively exploring pre-clerkship students' perceptions of the transition to clerkship training we identified expectations and misconceptions that could be addressed with future curricular interventions. While students are aware of and anticipating their learning needs it is not as clear that they realise how much their future learning will depend on their own inner resources. We suggest that more attention be paid to professional identity formation and the development of the physician as a person during these critical transitions.

NNSA/NV Consequence Management Capabilities for Radiological Emergency Response

International Nuclear Information System (INIS)

Bowman, D. R.

2002-01-01

The U.S. Department of Energy's National Nuclear Security Administration Nevada Operations Office (NNSA/NV) provides an integrated Consequence Management (CM) response capability for the (NNSA) in the event of a radiological emergency. This encompasses planning, technical operations, and home team support. As the lead organization for CM planning and operations, NNSA/NV coordinates the response of the following assets during the planning and operational phases of a radiological accident or incident: (1) Predictive dispersion modeling through the Atmospheric Release Advisory Capability (ARAC) at Lawrence Livermore National Laboratory (LLNL) and the High Consequence Assessment Group at Sandia National Laboratories (SNL); (2) Regional radiological emergency assistance through the eight Radiological Assistance Program (RAP) regional response centers; (3) Medical advice and assistance through the Radiation Emergency Assistance Center/Training Site (REAC/TS) in Oak Ridge, Tennessee; (4) Aerial radiological mapping using the fixed-wing and rotor-wing aircraft of the Aerial Measuring System (AMS); (5) Consequence Management Planning Teams (CMPT) and Consequence Management Response Teams (CMRT) to provide CM field operations and command and control. Descriptions of the technical capabilities employed during planning and operations are given below for each of the elements comprising the integrated CM capability

Establishing a Research and Evaluation Capability for the Joint Medical Education and Training Campus.

Science.gov (United States)

Kirby, Sheila Nataraj; Marsh, Julie A; Thie, Harry J

2011-01-01

In calling for the transformation of military medical education and training, the 2005 Base Realignment and Closure Commission recommended relocating basic and specialty enlisted medical training to a single site to take advantage of economies of scale and the opportunity for joint training. As a result, a joint medical education and training campus (METC) has been established at Fort Sam Houston, Texas. Two of METC's primary long-term goals are to become a high-performing learning organization and to seek accreditation as a community college. Such goals require a clear model of organizational improvement with well-defined metrics for measuring its performance and using research and evaluation to assess and improve that performance. Lessons learned from a review of practices at institutions with similar missions-such as community colleges, corporate universities, the UK's Defence Medical Education and Training Agency, and other federal agencies, such as the Veterans Health Administration-establish a clear need for an office of institutional research to help METC attain its organizational goals. They also provide useful recommendations regarding the METC office's structure, scope, and governance.

Exploring the usefulness of comprehensive care plans for children with medical complexity (CMC: a qualitative study

Directory of Open Access Journals (Sweden)

Adams Sherri

2013-01-01

Full Text Available Abstract Background The Medical Home model recommends that Children with Special Health Care Needs (CSHCN receive a medical care plan, outlining the child’s major medical issues and care needs to assist with care coordination. While care plans are a primary component of effective care coordination, the creation and maintenance of care plans is time, labor, and cost intensive, and the desired content of the care plan has not been studied. The purpose of this qualitative study was to understand the usefulness and desired content of comprehensive care plans by exploring the perceptions of parents and health care providers (HCPs of children with medical complexity (CMC. Methods This qualitative study utilized in-depth semi-structured interviews and focus groups. HCPs (n = 15 and parents (n = 15 of CMC who had all used a comprehensive care plan were recruited from a tertiary pediatric academic health sciences center. Themes were identified through grounded theory analysis of interview and focus group data. Results A multi-dimensional model of perceived care plan usefulness emerged. The model highlights three integral aspects of the care plan: care plan characteristics, activating factors and perceived outcomes of using a care plan. Care plans were perceived as a useful tool that centralized and focused the care of the child. Care plans were reported to flatten the hierarchical relationship between HCPs and parents, resulting in enhanced reciprocal information exchange and strengthened relationships. Participants expressed that a standardized template that is family-centered and includes content relevant to both the medical and social needs of the child is beneficial when integrated into overall care planning and delivery for CMC. Conclusions Care plans are perceived to be a useful tool to both health care providers and parents of CMC. These findings inform the utility and development of a comprehensive care plan template as well as a model of how

Reform of the Method for Evaluating the Teaching of Medical Linguistics to Medical Students

Science.gov (United States)

Zhang, Hongkui; Wang, Bo; Zhang, Longlu

2014-01-01

Explorating reform of the teaching evaluation method for vocational competency-based education (CBE) curricula for medical students is a very important process in following international medical education standards, intensify ing education and teaching reforms, enhancing teaching management, and improving the quality of medical education. This…

Exploring the evidence base for how people with dementia and their informal carers manage their medication in the community: a mixed studies review.

Science.gov (United States)

Aston, Lydia; Hilton, Andrea; Moutela, Tiago; Shaw, Rachel; Maidment, Ian

2017-10-18

Little is known about the general medicines management issues for people with dementia living in the community. This review has three aims: firstly to explore and evaluate the international literature on how people with dementia manage medication; assess understanding of medicines management from an informal carers perspective; and lastly to understand the role that healthcare professionals play in assisting this population with medicines management. A mixed studies review was conducted. Web of Knowledge, PubMed and Cochrane Library were searched post-1999 for studies that explored medicines management in people with dementia dwelling in the community, and the role healthcare professionals play in supporting medicines management in people with dementia. Following screening, nine articles were included. Data from included studies were synthesised using a convergent synthesis approach and analysed thematically to combine findings from studies using a range of methods (qualitative, quantitative and mixed methods). Four themes were generated from the synthesis: The nature of the disease and the effects this had on medicines management; the additional responsibilities informal carers have; informal caregivers' knowledge of the importance of managing medication and healthcare professionals' understanding of medicines management in people with dementia. Consequently, these were found to affect management of medication, in particular adherence to medication. This review has identified that managing medication for people with dementia dwelling in the community is a complex task with a frequently associated burden on their informal caregivers. Healthcare professionals can be unaware of this burden. The findings warrant the need for healthcare professionals to undergo further training in supporting medicines management for people with dementia in their own homes.

Exploring the transition of undergraduate medical students into a clinical clerkship using organizational socialization theory.

Science.gov (United States)

Atherley, Anique E; Hambleton, Ian R; Unwin, Nigel; George, Colette; Lashley, Paula M; Taylor, Charles G

2016-04-01

Transitions in medical education are emotionally and socially dynamic; this may affect learning. Students transitioning from preclinical to clinical training may experience negative consequences. Less is understood about students' experiences during transitions within clinical training and influential factors. The authors used organizational socialization theory to explore a transition within the clinical years. Final-year medical students experienced a nine-week internal medicine clerkship; willing students participated. Students (n = 101; 97 %) completed a questionnaire with open-ended questions at the beginning and end of the clerkship and participated in six consecutive focus groups, until data saturation occurred (n = 37). Data were thematically analyzed. Socialization was challenging. Many students experienced difficulty developing relationships with team members. Students with a positive attitude experienced a smoother transition. Many students were uncertain of their roles, concerned about the workload and desired guidance to meet clerkship demands. This transition resulted in varied outcomes from enjoyment, increased confidence and student development through to disinterest. Transitions within clinical training are complex. Faculty should focus on adequate socialization in a new clerkship as this may facilitate a smoother transition. This may necessitate orientations, staff training, and formal student support. Further research is needed on the impact of these recommendations on learning and well-being.

Exploring behavioural determinants relating to health professional reporting of medication errors: a qualitative study using the Theoretical Domains Framework.

Science.gov (United States)

Alqubaisi, Mai; Tonna, Antonella; Strath, Alison; Stewart, Derek

2016-07-01

Effective and efficient medication reporting processes are essential in promoting patient safety. Few qualitative studies have explored reporting of medication errors by health professionals, and none have made reference to behavioural theories. The objective was to describe and understand the behavioural determinants of health professional reporting of medication errors in the United Arab Emirates (UAE). This was a qualitative study comprising face-to-face, semi-structured interviews within three major medical/surgical hospitals of Abu Dhabi, the UAE. Health professionals were sampled purposively in strata of profession and years of experience. The semi-structured interview schedule focused on behavioural determinants around medication error reporting, facilitators, barriers and experiences. The Theoretical Domains Framework (TDF; a framework of theories of behaviour change) was used as a coding framework. Ethical approval was obtained from a UK university and all participating hospital ethics committees. Data saturation was achieved after interviewing ten nurses, ten pharmacists and nine physicians. Whilst it appeared that patient safety and organisational improvement goals and intentions were behavioural determinants which facilitated reporting, there were key determinants which deterred reporting. These included the beliefs of the consequences of reporting (lack of any feedback following reporting and impacting professional reputation, relationships and career progression), emotions (fear and worry) and issues related to the environmental context (time taken to report). These key behavioural determinants which negatively impact error reporting can facilitate the development of an intervention, centring on organisational safety and reporting culture, to enhance reporting effectiveness and efficiency.

Explore and experience: mobile augmented reality for medical training.

Science.gov (United States)

Albrecht, Urs-Vito; Noll, Christoph; von Jan, Ute

2013-01-01

In medicine, especially in basic education, it may sometimes be inappropriate to integrate real patients into classes due to ethical issues that must be avoided. Nevertheless, the quality of medical education may suffer without the use of real cases. This is especially true of medical specialties such as legal medicine: survivors of a crime are already subjected to procedures that constitute a severe emotional burden and may cause additional distress even without the added presence of students. Using augmented reality based applications may alleviate this ethical dilemma by giving students the possibility to practice the necessary skills based on virtual but nevertheless almost realistic cases. The app "mARble®" that is presented in this paper follows this approach. The currently available learning module for legal medicine gives users an opportunity to learn about various wound patterns by virtually overlaying them on their own skin and is applicable in different learning settings. Preliminary evaluation results covering learning efficiency and emotional components of the learning process are promising. Content modules for other medical specialtiesare currently under construction.

Advances in Autonomous Systems for Missions of Space Exploration

Science.gov (United States)

Gross, A. R.; Smith, B. D.; Briggs, G. A.; Hieronymus, J.; Clancy, D. J.

New missions of space exploration will require unprecedented levels of autonomy to successfully accomplish their objectives. Both inherent complexity and communication distances will preclude levels of human involvement common to current and previous space flight missions. With exponentially increasing capabilities of computer hardware and software, including networks and communication systems, a new balance of work is being developed between humans and machines. This new balance holds the promise of meeting the greatly increased space exploration requirements, along with dramatically reduced design, development, test, and operating costs. New information technologies, which take advantage of knowledge-based software, model-based reasoning, and high performance computer systems, will enable the development of a new generation of design and development tools, schedulers, and vehicle and system health monitoring and maintenance capabilities. Such tools will provide a degree of machine intelligence and associated autonomy that has previously been unavailable. These capabilities are critical to the future of space exploration, since the science and operational requirements specified by such missions, as well as the budgetary constraints that limit the ability to monitor and control these missions by a standing army of ground- based controllers. System autonomy capabilities have made great strides in recent years, for both ground and space flight applications. Autonomous systems have flown on advanced spacecraft, providing new levels of spacecraft capability and mission safety. Such systems operate by utilizing model-based reasoning that provides the capability to work from high-level mission goals, while deriving the detailed system commands internally, rather than having to have such commands transmitted from Earth. This enables missions of such complexity and communications distance as are not otherwise possible, as well as many more efficient and low cost

Communication between office-based primary care providers and nurses working within patients' homes: an analysis of process data from CAPABLE.

Science.gov (United States)

Smith, Patrick D; Boyd, Cynthia; Bellantoni, Julia; Roth, Jill; Becker, Kathleen L; Savage, Jessica; Nkimbeng, Manka; Szanton, Sarah L

2016-02-01

To examine themes of communication between office-based primary care providers and nurses working in private residences; to assess which methods of communication elicit fruitful responses to nurses' concerns. Lack of effective communication between home health care nurses and primary care providers contributes to clinical errors, inefficient care delivery and decreased patient safety. Few studies have described best practices related to frequency, methods and reasons for communication between community-based nurses and primary care providers. Secondary analysis of process data from 'Community Aging in Place: Advancing Better Living for Elders (CAPABLE)'. Independent reviewers analysed nurse documentation of communication (phone calls, letters and client coaching) initiated for 70 patients and analysed 45 letters to primary care providers to identify common concerns and recommendations raised by CAPABLE nurses. Primary care providers responded to 86% of phone calls, 56% of letters and 50% of client coaching efforts. Primary care providers addressed 86% of concerns communicated by phone, 34% of concerns communicated by letter and 41% of client-raised concerns. Nurses' letters addressed five key concerns: medication safety, pain, change in activities of daily living, fall safety and mental health. In letters, CAPABLE nurses recommended 58 interventions: medication change; referral to a specialist; patient education; and further diagnostic evaluation. Effective communication between home-based nurses and primary care providers enhances care coordination and improves outcomes for home-dwelling elders. Various methods of contact show promise for addressing specific communication needs. Nurses practicing within patients' homes can improve care coordination by using phone calls to address minor matters and written letters for detailed communication. Future research should explore implementation of Situation, Background, Assessment and Recommendation in home care to promote

Artificial intelligence for Space Station automation: Crew safety, productivity, autonomy, augmented capability

Science.gov (United States)

Firschein, O.; Georgeff, M. P.; Park, W.; Cheeseman, P. C.; Geldberg, J.

1986-01-01

Artificial intelligence (AI) R&D projects for the successful and efficient operation of the Space Station are described. The book explores the most advanced AI-based technologies, reviews the results of concept design studies to determine required AI capabilities, details demonstrations that would indicate the existence of these capabilities, and develops an R&D plan leading to such demonstrations. Particular attention is given to teleoperation and robotics, sensors, expert systems, computers, planning, and man-machine interface.

Explor@ Advisory Agent: Tracing the Student's Trail.

Science.gov (United States)

Lundgren-Cayrol, Karin; Paquette, Gilbert; Miara, Alexis; Bergeron, Frederick; Rivard, Jacques; Rosca, Ioan

This paper presents research and development of an adaptive World Wide Web-based system called Explor@ Advisory Agent, capable of tailoring advice to the individual student's needs, actions, and reactions toward pedagogical events, as well as according to diagnosis of content acquisition. Explor@ Advisory Agent consists of two sub-systems, the…

Dynamic capabilities, Marketing Capability and Organizational Performance

Directory of Open Access Journals (Sweden)

Adriana Roseli Wünsch Takahashi

2017-01-01

Full Text Available The goal of the study is to investigate the influence of dynamic capabilities on organizational performance and the role of marketing capabilities as a mediator in this relationship in the context of private HEIs in Brazil. As a research method we carried out a survey with 316 IES and data analysis was operationalized with the technique of structural equation modeling. The results indicate that the dynamic capabilities have influence on organizational performance only when mediated by marketing ability. The marketing capability has an important role in the survival, growth and renewal on educational services offerings for HEIs in private sector, and consequently in organizational performance. It is also demonstrated that mediated relationship is more intense for HEI with up to 3,000 students and other organizational profile variables such as amount of courses, the constitution, the type of institution and type of education do not significantly alter the results.

Building Dynamic Capabilities in Web Startups: An Empirical Study of Norwegian Web Startups

OpenAIRE

Sahlen, Martin Abelson; Gran-Jansen, Sigurd; Rygh, Mathias

2014-01-01

Purpose: This thesis explores how web startups operating in a crowded, fast-moving and highly competitive marketplace can gain competitive advantage through building dynamic capabilities and what these capabilities consist of. Design/methodology/approach: Firstly, insight was obtained through reviewing key themes within classic resource based theory and entrepreneurship theory. Newer empirical research on entrepreneurial success factors, as well as popular science and advice given by expert w...

[Mobile phone-computer wireless interactive graphics transmission technology and its medical application].

Science.gov (United States)

Huang, Shuo; Liu, Jing

2010-05-01

Application of clinical digital medical imaging has raised many tough issues to tackle, such as data storage, management, and information sharing. Here we investigated a mobile phone based medical image management system which is capable of achieving personal medical imaging information storage, management and comprehensive health information analysis. The technologies related to the management system spanning the wireless transmission technology, the technical capabilities of phone in mobile health care and management of mobile medical database were discussed. Taking medical infrared images transmission between phone and computer as an example, the working principle of the present system was demonstrated.

Medical applications of artificial intelligence

CERN Document Server

Agah, Arvin

2013-01-01

Enhanced, more reliable, and better understood than in the past, artificial intelligence (AI) systems can make providing healthcare more accurate, affordable, accessible, consistent, and efficient. However, AI technologies have not been as well integrated into medicine as predicted. In order to succeed, medical and computational scientists must develop hybrid systems that can effectively and efficiently integrate the experience of medical care professionals with capabilities of AI systems. After providing a general overview of artificial intelligence concepts, tools, and techniques, Medical Ap

Medical academia clinical experiences of Ward Round Teaching curriculum.

Science.gov (United States)

Haghani, Fariba; Arabshahi, Seyed Kamran Soltani; Bigdeli, Shoaleh; Alavi, Mousa; Omid, Athar

2014-01-01

Medical students spend most of their time in hospital wards and it is necessary to study clinical educational opportunities. This study was aimed to explore faculty members' experience on Ward Round Teaching content. This qualitative study was conducted by purposive sampling with the maximum variation of major clinical departments faculty members in Isfahan University of Medical Sciences (n = 9). Data gathering was based on deep and semi-structured interviews. Data gathering continued till data saturation. Data was analyzed through the Collaizzi method and validated. Strategies to ensure trustworthiness of data (credibility, dependability, conformability, transferability) were employed (Guba and Lincoln). Basic codes extracted from the analyzed data were categorized into two main themes and related subthemes, including (1) tangible teachings (analytic intelligence, technical intelligence, legal duties) and (2) implied teachings (professionalism, professional discipline, professional difficulties). Ward round teaching is a valuable opportunity for learners to learn not only patient care aspects but also ethical values. By appropriate planning, opportunities can be used to teach capabilities that are expected of general practitioners.

Medical academia clinical experiences of Ward Round Teaching curriculum

Directory of Open Access Journals (Sweden)

Fariba Haghani

2014-01-01

Full Text Available Background: Medical students spend most of their time in hospital wards and it is necessary to study clinical educational opportunities. This study was aimed to explore faculty members′ experience on Ward Round Teaching content. Methods and Materials: This qualitative study was conducted by purposive sampling with the maximum variation of major clinical departments faculty members in Isfahan University of Medical Sciences (n = 9. Data gathering was based on deep and semi-structured interviews. Data gathering continued till data saturation.Data was analyzed through the Collaizzi method and validated. Strategies to ensure trustworthiness of data (credibility, dependability, conformability, transferability were employed (Guba and Lincoln. Results: Basic codes extracted from the analyzed data were categorized into two main themes and related subthemes, including (1 tangible teachings (analytic intelligence, technical intelligence, legal duties and (2 implied teachings (professionalism, professional discipline, professional difficulties. Conclusion: Ward round teaching is a valuable opportunity for learners to learn not only patient care aspects but also ethical values. By appropriate planning, opportunities can be used to teach capabilities that are expected of general practitioners.

An analysis of historical data on uranium exploration expenditures and price

International Nuclear Information System (INIS)

Price, R.R.

2006-01-01

Exploration expenditures (especially in constant dollars) are a good indicator of exploration activity and there is an excellent correlation between them and uranium price with the influence of a price increase in uranium greatest one to two years after the price change. Recent prices, though increasing from all-time lows, still remain relatively low when expressed in constant dollars. This, as yet, modest price increase though can still be expected to stimulate significantly increased exploration activity. However, since the impact can be expected to be seen only one to two years after a price increase, any increases in exploration will still be in progress and will only be fully revealed over the next several years. With reactor requirements to be increasingly met by primary production in coming years, it is necessary to ensure that sufficient new discoveries of uranium are made to permit expansion of production capability as secondary sources decline. Increased exploration activity will be needed to provide the resource base needed to build new or expand existing production capability. An analysis of historical information indicates that past price increases have resulted in increased exploration. Recent price increases, therefore, can be expected to begin the increased exploration needed to support the expansion of uranium production capability

The Influence of Industry Characteristics and Dynamic Capabilities on Firms’ Profitability

Directory of Open Access Journals (Sweden)

Maja Pervan

2017-12-01

Full Text Available The aim of this research was to explore one of the most intriguing dimensions of every firm’s business—its performance. Aside from analysing the influence of industry’s characteristics on the firm’s performance, the authors addressed the characteristics of dynamic capabilities and their role in contribution to the firm’s ultimate success. The analysis was conducted on a sample of 118 small Croatian manufacturing companies. The application of the Structural Equation Modelling (SEM approach revealed a statistically significant influence of both the industry’s characteristics (represented by Porter’s five forces framework and dynamic capabilities (based on Teece’s theory on the firm’s performance, where the influence of dynamic capabilities is proven to be larger than that of the industry.

Sandia Laboratories technical capabilities. Auxiliary capabilities: environmental health information science

International Nuclear Information System (INIS)

1975-09-01

Sandia Laboratories is an engineering laboratory in which research, development, testing, and evaluation capabilities are integrated by program management for the generation of advanced designs. In fulfilling its primary responsibility to ERDA, Sandia Laboratories has acquired extensive research and development capabilities. The purpose of this series of documents is to catalog the many technical capabilities of the Laboratories. After the listing of capabilities, supporting information is provided in the form of highlights, which show applications. This document deals with auxiliary capabilities, in particular, environmental health and information science. (11 figures, 1 table) (RWR)

Assessment of Medical Risks and Optimization of their Management using Integrated Medical Model

Science.gov (United States)

Fitts, Mary A.; Madurai, Siram; Butler, Doug; Kerstman, Eric; Risin, Diana

2008-01-01

The Integrated Medical Model (IMM) Project is a software-based technique that will identify and quantify the medical needs and health risks of exploration crew members during space flight and evaluate the effectiveness of potential mitigation strategies. The IMM Project employs an evidence-based approach that will quantify probability and consequences of defined in-flight medical risks, mitigation strategies, and tactics to optimize crew member health. Using stochastic techniques, the IMM will ultimately inform decision makers at both programmatic and institutional levels and will enable objective assessment of crew health and optimization of mission success using data from relevant cohort populations and from the astronaut population. The objectives of the project include: 1) identification and documentation of conditions that may occur during exploration missions (Baseline Medical Conditions List [BMCL), 2) assessment of the likelihood of conditions in the BMCL occurring during exploration missions (incidence rate), 3) determination of the risk associated with these conditions and quantify in terms of end states (Loss of Crew, Loss of Mission, Evacuation), 4) optimization of in-flight hardware mass, volume, power, bandwidth and cost for a given level of risk or uncertainty, and .. validation of the methodologies used.

Exploring Jahrom Medical University students' attitudes towards the ...

African Journals Online (AJOL)

Introduction: Self- evaluation is the process of designing, building and maintaining human behaviors that can lead to maturity and perfection. Therefore, the aim of this study is to examine Jahrom Medical University students' attitudes towards the Islamic self-assessment in 2015. Method: This cross-sectional and descriptive ...

A Situation Awareness Assistant for Human Deep Space Exploration

Science.gov (United States)

Boy, Guy A.; Platt, Donald

2013-01-01

This paper presents the development and testing of a Virtual Camera (VC) system to improve astronaut and mission operations situation awareness while exploring other planetary bodies. In this embodiment, the VC is implemented using a tablet-based computer system to navigate through inter active database application. It is claimed that the advanced interaction media capability of the VC can improve situation awareness as the distribution of hu man space exploration roles change in deep space exploration. The VC is being developed and tested for usability and capability to improve situation awareness. Work completed thus far as well as what is needed to complete the project will be described. Planned testing will also be described.

Cyber-physical augmentation : An exploration

NARCIS (Netherlands)

Vroom, R.W.; Horvath, I.

2014-01-01

Ubiquitous technologies provide many product innovation opportunities for industrial design engineers, such as creating user centered cyber-physical systems with adaptive capabilities to individual users and environments. The exploration discussed in this paper aims to uncover needs to know for

NEW GROWTH PLATFORM FRAMEWORK FOR SWISS ACUTE HOSPITALS - AN EMPIRICAL STUDY FOR THE DEVELOPMENT OF DYNAMIC CAPABILITIES

Directory of Open Access Journals (Sweden)

Zoran Alimpic

2013-11-01

Full Text Available Swiss health care is confronted with fundamental changes. On the one hand, there are increasing costs in patient treatments, caused by innovative technology with new high-capacity medical devices, and a lack of effectiveness and efficiency in the organisation of a hospital. On the other hand, hospitals do have decreasing revenues with the introduction of the new patient classification and tariff system DRG (Diagnosis Related Groups by 2012. For every DRG, hospitals will receive a fixed price, separate from the actual costs of the patient treatment. In this paper it was explored the case of 13 successful Swiss private acute hospitals which are also confronted with these pressures to reduce their costs of patient treatment and therefore to optimise their processes of care. This research focuses on dynamic capabilitie of the hospitals. Although dynamic capabilities are idiosyncratic in their details and path dependent in their emergence, they have significant ‘best practise’ across firms (Eisenhardt and Martin, 2000. The research is started with the evaluation of new trends, key customers’ needs, and capabilities, with questionnaires for attending physicians and hospital managers. The NGP approach gives hospital managers the enough crucial information for a strategy formulation in fundamental changing environments, which is the key contribution of this manuscript.

Dynamic Capabilities and Firm Performance: A Case of Two SMEs in Pakistan

Directory of Open Access Journals (Sweden)

Qazi Muhammad Moinuddin Abro

2011-07-01

Full Text Available This paper investigates the inter-relationship among entrepreneurship, dynamic capabilities and innovation. Entrepreneur\\'s foresights and insights of ICT (Information and Communication Technologies tend to affect their choices of resources and development of dynamic capabilities, leading to different results of innovation. Based on the literature of business innovation and dynamic capabilities, this paper provides a model addressing the links between leadership, with insights and foresights for technology exploration and exploitation, and organizational capabilities of resource integration, learning and transformation to accelerate innovation. A comparative analysis of the two textile manufacturers in Pakistan revealed a cyclical process between the leadership decisions and dynamic capabilities of leveraging ICT for sustained competitiveness in these two SMEs (Small and Medium Sized Enterprises. The result suggests that to build strong capabilities for continuous innovation in today\\'s dynamic business environment, firms need to have leadership with both the attitude and behavior of entrepreneurship, combining the foresight to capture opportunities through ICT and the insight to guide and manage internal resources to achieve ICT-enabled innovation.

Production of Medical Isotopes with Electron Linacs

Energy Technology Data Exchange (ETDEWEB)

Rotsch, D A; Alford, K.; Bailey, J. L.; Bowers, D. L.; Brossard, T.; Brown, M. A.; Chemerisov, S. D.; Ehst, D.; Greene, J.; Gromov, R. G.; Grudzinski, J.J.; Hafenrichter, L.; Hebden, A. S.; Henning, W.; Heltemes, T. A.; Jerden, J.; Jonah, C. D.; Kalensky, M.; Krebs, J. F.; Makarashvili, V.; Micklich, B.; Nolen, J.; Quigley, K. J.; Schneider, J. F.; Smith, N. A.; Stepinski, D. C.; Sun, Z.; Tkac, P.; Vandegrift, G. F.; Virgo, M J; Wesolowski, K. A.; Youker, A. J.

2017-06-01

Radioisotopes play important roles in numerous areas ranging from medical treatments to national security and basic research. Radionuclide production technology for medical applications has been pursued since the early 1900s both commercially and in nuclear science centers. Many medical isotopes are now in routine production and are used in day-to-day medical procedures. Despite these advancements, research is accelerating around the world to improve the existing production methodologies as well as to develop novel radionuclides for new medical appli-cations. Electron linear accelerators (linacs) represent a unique method for the production of radioisotopes. Even though the basic technology has been around for decades, only recently have electron linacs capable of producing photons with sufficient energy and flux for radioisotope production become available. Housed in Argonne Nation-al Laboratory’s Low Energy Accelerator Facility (LEAF) is a newly upgraded 55 MeV/25-kW electron linear ac-celerator, capable of producing a wide range of radioiso-topes. This talk will focus on the work being performed for the production of the medical isotopes 99Mo (99Mo/99mTc generator), 67Cu, and 47Sc.

Medical judgement analogue studies with applications to spaceflight crew medical officer.

Science.gov (United States)

McCarroll, Michele L; Ahmed, Rami A; Schwartz, Alan; Gothard, Michael David; Atkinson, Steven Scott; Hughes, Patrick; Brito, Jose Cepeda; Assad, Lori; Myers, Jerry; George, Richard L

2017-10-01

The National Aeronautics and Space Administration (NASA) developed plans for potential emergency conditions from the Exploration Medical Conditions List. In an effort to mitigate conditions on the Exploration Medical Conditions List, NASA implemented a crew medical officer (CMO) designation for eligible astronauts. This pilot study aims to add knowledge that could be used in the Integrated Medical Model. An analogue population was recruited for two categories: administrative physicians (AP) representing the physician CMOs and technical professionals (TP) representing the non-physician CMOs. Participants completed four medical simulations focused on abdominal pain: cholecystitis (CH) and renal colic (RC) and chest pain: cardiac ischaemia (STEMI; ST-segment elevation myocardial infarction) and pneumothorax (PX). The Medical Judgment Metric (MJM) was used to evaluate medical decision making. There were no significant differences between the AP and TP groups in age, gender, race, ethnicity, education and baseline heart rate. Significant differences were noted in MJM average rater scores in AP versus TP in CH: 13.0 (±2.25), 4.5 (±0.48), p=<0.001; RC: 12.3 (±2.66), 4.8 (±0.94); STEMI: 12.1 (±3.33), 4.9 (±0.56); and PX: 13.5 (±2.53), 5.3 (±1.01), respectively. There could be a positive effect on crew health risk by having a physician CMO. The MJM demonstrated the ability to quantify medical judgement between the two analogue groups of spaceflight CMOs. Future studies should incorporate the MJM in a larger analogue population study to assess the medical risk for spaceflight crewmembers.

A multi-institutional study exploring the impact of positive mental health on medical students' professionalism in an era of high burnout.

Science.gov (United States)

Dyrbye, Liselotte N; Harper, William; Moutier, Christine; Durning, Steven J; Power, David V; Massie, F Stanford; Eacker, Anne; Thomas, Matthew R; Satele, Daniel; Sloan, Jeff A; Shanafelt, Tait D

2012-08-01

Although burnout is associated with erosion of professionalism and serious personal consequences, whether positive mental health can enhance professionalism and how it shapes personal experience remain poorly understood. The study simultaneously explores the relationship between positive mental health and burnout with professionalism and personal experience. The authors surveyed 4,400 medical students at seven U.S. medical schools in 2009 to assess mental health (categorized as languishing, moderate, and flourishing) and burnout. Additional items explored professional behaviors, beliefs, suicidal ideation, and serious thoughts of dropping out. A total of 2,682/4,400 (61%) responded. Prevalence of suicidal ideation (55/114 [48.2%], 281/1,128 [24.9%], and 127/1,409 [9.1%]) and serious thoughts of dropping out (15/114 [13.2%], 30/1,128 [2.7%], and 14/1,409 [1.0%]) decreased as mental health improved from languishing, moderate, and flourishing, respectively (all P mental health persisted independent of burnout (all P mental health improved, the prevalence of unprofessional behaviors (i.e., cheating and dishonest behaviors) also declined, whereas students' altruistic beliefs regarding physicians' responsibility toward society improved. For example, 33/113 (29.2%), 426/1,120 (38.0%), and 718/1,391 (51.6%) of students with languishing, moderate, and flourishing mental health endorsed all five altruistic professional beliefs (P mental health persisted among students with burnout, whereas fewer relationships were found among students without burnout. Findings suggest that positive mental health attenuates some adverse consequences of burnout. Medical student wellness programs should aspire to prevent burnout and promote mental health.

Portrayal of medical decision making around medical interventions life-saving encounters on three medical television shows.

Science.gov (United States)

Schwei, Rebecca J; Jacobs, Elizabeth A; Wingert, Katherine; Montague, Enid

2015-07-01

Previous literature has shown that patients obtain information about the medical system from television shows. Additionally, shared decision making is regularly cited as the ideal way to make decisions during a medical encounter. Little information exists surrounding the characteristics of medical decision-making, such as who makes the decision, on medical television shows. We evaluate the characteristics of medical decisions in lifesaving encounters on medical television shows and evaluate if these characteristics were different on staged and reality television shows. We coded type of medical intervention, patient's ability to participate in decision, presence of patient advocate during decision, final decision maker, decision to use intervention, and controversy surrounding decision on three television shows. Frequencies by show were calculated and differences across the three television shows and between staged (ER) and reality ( BostonMed and Hopkins ) television shows were assessed with chi-square tests. The final data set included 37 episodes, 137 patients and 593 interventions. On ER, providers were significantly more likely to make the decision about the medical intervention without informing the patient when a patient was capable of making a decision compared to BostonMed or Hopkins (ptelevision shows we analyzed. It is possible that what patients see on television influences their expectations surrounding the decision making process and the use of medical interventions in everyday healthcare encounters.

Researching pharmacist managerial capability: philosophical perspectives and paradigms of inquiry.

Science.gov (United States)

Woods, Phillip; Gapp, Rod; King, Michelle A

2015-01-01

In successful community pharmacy business enterprises suitably responsive actions to meet ever-increasing change require capable pharmacy managers who readily learn and adapt. Capability as a concept is generally understood to be the ability of a manager to identify and act to solve unfamiliar problems in unfamiliar situations. Capability is characterized by adaptability and flexibility. However, different understandings of the concept 'capability' and what it means to be 'capable' are indirect and incomplete. This paper aims to clarify current theories regarding the concept of 'capability' at the level of the individual, and through this to make more explicit what is known about the phenomenon, but more particularly, how we know what we know. The analysis includes the concept of 'competence' because explanations of capability include competence, and the two concepts are not clearly separated in the literature. By probing the epistemological origins of current theory concerning both concepts, the limiting taken for granted assumptions are revealed. Assumptions about context and time, and the psychological theory through which individuals are assumed to perceive, know and learn, are illuminated. The analysis, in connection with the literature, shows how the interpretive philosophic research approach may reveal a different and useful theoretical perspective for explaining capability as a dynamic performance. It is suggested that such a perspective may narrow the gap between the theory of capability and its practice. The interpretive perspective holds potential to reveal how capability, as performed by successful community pharmacy managers, might be further researched and strengthened. This paper supports the challenging suggestion that pharmacy social research needs to rebalance the dominance of purely empirical research by exploring interpretive methodologies to better understand human actions and relations in the context of pharmacy. Crown Copyright © 2015

A Capabilities-Friendly Conceptualisation of Flourishing in and through Education

Science.gov (United States)

Wilson-Strydom, Merridy; Walker, Melanie

2015-01-01

This article explores what it means to flourish in and through education and why we should position such flourishing as an issue of morality. We draw on the capabilities approach (CA) advanced by Amartya Sen and Martha Nussbaum and locate the argument in the practical context of higher education (HE) in unequal societies. We use qualitative data…

MEDIC: medical embedded device for individualized care.

Science.gov (United States)

Wu, Winston H; Bui, Alex A T; Batalin, Maxim A; Au, Lawrence K; Binney, Jonathan D; Kaiser, William J

2008-02-01

Presented work highlights the development and initial validation of a medical embedded device for individualized care (MEDIC), which is based on a novel software architecture, enabling sensor management and disease prediction capabilities, and commercially available microelectronic components, sensors and conventional personal digital assistant (PDA) (or a cell phone). In this paper, we present a general architecture for a wearable sensor system that can be customized to an individual patient's needs. This architecture is based on embedded artificial intelligence that permits autonomous operation, sensor management and inference, and may be applied to a general purpose wearable medical diagnostics. A prototype of the system has been developed based on a standard PDA and wireless sensor nodes equipped with commercially available Bluetooth radio components, permitting real-time streaming of high-bandwidth data from various physiological and contextual sensors. We also present the results of abnormal gait diagnosis using the complete system from our evaluation, and illustrate how the wearable system and its operation can be remotely configured and managed by either enterprise systems or medical personnel at centralized locations. By using commercially available hardware components and software architecture presented in this paper, the MEDIC system can be rapidly configured, providing medical researchers with broadband sensor data from remote patients and platform access to best adapt operation for diagnostic operation objectives.

THEORY OF REASONED ACTION FOR CONTINUOUS IMPROVEMENT CAPABILITIES: A BEHAVIORAL APPROACH

Directory of Open Access Journals (Sweden)

Janaina Siegler

2012-09-01

Full Text Available The importance of interaction between Operations Management (OM and Human Behavior has been recently re-addressed. This paper introduced the Reasoned Action Theory suggested by Froehle and Roth (2004 to analyze Operational Capabilities exploring the suitability of this model in the context of OM. It also seeks to discuss the behavioral aspects of operational capabilities from the perspective of organizational routines. This theory was operationalized using Fishbein and Ajzen (F/A behavioral model and a multi-case strategy was employed to analyze the Continuous Improvement (CI capability. The results posit that the model explains partially the CI behavior in an operational context and some contingency variables might influence the general relationsamong the variables involved in the F/A model. Thus intention might not be the determinant variable of behavior in this context.

The Muddle of Medicalization

DEFF Research Database (Denmark)

Sholl, Jonathan

2017-01-01

to describe inappropriate or abusive instances of medical authority. Yet, while this standard approach claims that medicalization is a growing problem, it assumes that there is simply one “medical model” and that the expanding realm of “the medical” can be more or less clearly delineated. Moreover, while...... of medical discourse. In doing so, I will explore the distinction between medicalization and pathologization, a distinction that is often overlooked and that brings with it many conceptual and practical implications. After defining these terms, I will use some examples to show that while pathologizing...

Handheld Diagnostic Device Delivers Quick Medical Readings

Science.gov (United States)

2014-01-01

To monitor astronauts' health remotely, Glenn Research Center awarded SBIR funding to Cambridge, Massachusetts-based DNA Medical Institute, which developed a device capable of analyzing blood cell counts and a variety of medical biomarkers. The technology will prove especially useful in rural areas without easy access to labs.

Heavy Lift for Exploration: Options and Utilization

Science.gov (United States)

Creech, Steve; Sumrall, Phil

2010-01-01

Every study of exploration capabilities since the Apollo Program has recommended the renewal of a heavy lift launch capability for the United States. NASA is aggressively pursuing that capability. This paper will discuss several aspects of that effort and the potential uses for that heavy lift capability. The need for heavy lift was cited most recent in the findings of the Review of U.S. Human Space Flight Plans Committee. Combined with considerations of launch availability and on-orbit operations, the Committee finds that exploration will benefit from the availability of a heavy-lift vehicle, the report said. In addition, heavy lift would enable the launching of large scientific observatories and more capable deep-space missions. It may also provide benefit in national security applications. The most recent focus of NASA s heavy lift effort is the Ares V cargo launch vehicle, which is part of the Constellation Program architecture for human exploration beyond low Earth orbit (LEO). The most recent point-of-departure configuration of the Ares V was approved during the Lunar Capabilities concept Review (LCCR) in 2008. The Ares V first stage propulsion system consists of a core stage powered by six commercial liquid hydrogen/liquid oxygen (LH2/LOX) RS-68 engines, flanked by two 5.5-segment solid rocket boosters (SRBs) based on the 5-segment Ares I first stage. The boosters use the same Polybutadiene Acrylonitrile (PBAN) propellant as the Space Shuttle. Atop the core stage is the Earth departure stage (EDS), powered by a single J-2X upper stage engine based on the Ares I upper stage engine. The 33-foot-diameter payload shroud can enclose a lunar lander, scientific instruments, or other payloads. Since LCCR, NASA has continued to refine the design through several successive internal design cycles. In addition, NASA has worked to quantify the broad national consensus for heavy lift in ways that, to the extent possible, meet the needs of the user community.

Composites for Exploration Upper Stage

Science.gov (United States)

Fikes, J. C.; Jackson, J. R.; Richardson, S. W.; Thomas, A. D.; Mann, T. O.; Miller, S. G.

2016-01-01

The Composites for Exploration Upper Stage (CEUS) was a 3-year, level III project within the Technology Demonstration Missions program of the NASA Space Technology Mission Directorate. Studies have shown that composites provide important programmatic enhancements, including reduced weight to increase capability and accelerated expansion of exploration and science mission objectives. The CEUS project was focused on technologies that best advanced innovation, infusion, and broad applications for the inclusion of composites on future large human-rated launch vehicles and spacecraft. The benefits included near- and far-term opportunities for infusion (NASA, industry/commercial, Department of Defense), demonstrated critical technologies and technically implementable evolvable innovations, and sustained Agency experience. The initial scope of the project was to advance technologies for large composite structures applicable to the Space Launch System (SLS) Exploration Upper Stage (EUS) by focusing on the affordability and technical performance of the EUS forward and aft skirts. The project was tasked to develop and demonstrate critical composite technologies with a focus on full-scale materials, design, manufacturing, and test using NASA in-house capabilities. This would have demonstrated a major advancement in confidence and matured the large-scale composite technology to a Technology Readiness Level 6. This project would, therefore, have bridged the gap for providing composite application to SLS upgrades, enabling future exploration missions.

Emergency Medical Service (EMS): Rotorcraft Technology Workshop

Science.gov (United States)

Bauchspies, J. S.; Adams, R. J.

1981-01-01

A lead organization on the national level should be designated to establish concepts, locations, and the number of shock trauma air medical services. Medical specialists desire a vehicle which incorporates advances in medical technology trends in health care. Key technology needs for the emergency medical services helicopter of the future include the riding quality of fixed wing aircraft (reduced noise and vibration), no tail rotor, small rotor, small rotor diameter, improved visibility, crashworthy vehicle, IFR capability, more affordability high reliability, fuel efficient, and specialized cabins to hold medical/diagnostic and communications equipment. Approaches to a national emergency medical service are discussed.

Capability ethics

OpenAIRE

Robeyns, Ingrid

2012-01-01

textabstractThe capability approach is one of the most recent additions to the landscape of normative theories in ethics and political philosophy. Yet in its present stage of development, the capability approach is not a full-blown normative theory, in contrast to utilitarianism, deontological theories, virtue ethics, or pragmatism. As I will argue in this chapter, at present the core of the capability approach is an account of value, which together with some other (more minor) normative comm...

Collaborative Capability in Coworking Spaces: Convenience Sharing or Community Building?

Directory of Open Access Journals (Sweden)

Marcelo F. Castilho

2017-12-01

Full Text Available This study explores the development of collaborative capability in coworking spaces. It is based on the perception of collaboration among 31 coworking founders, community managers, and coworkers of those spaces. In-depth interviews around the meaning of collaboration and its challenges were conducted in 14 coworking spaces located in six Asian countries. A set of factors was identified and a model was proposed based on a set of four dimensions: enabling knowledge sharing, enhancing a creative field, enhancing an individual action for the collective, and supporting a collective action to an effective execution. The “Convenience Sharing” and “Community Building” coworking types based on Capdevila (2014 suggest different conditions under which collaborative capability develops. Convenience Sharing coworking spaces tend to foster collaborative capability through knowledge sharing and effective execution, whereas Community Building coworking spaces tend to foster collaborative capability by enhancing a creative field and individual action for the collective. Overall, this study contributes to a theoretical model for coworking spaces to help coworking founders and community managers make strategic decisions. The findings suggest that collaborative capability in coworking spaces depends on the interlacing of a set of factors along four dimensions that relate in varying degrees of intensity to a two-fold coworking space typology.

SMS-Based Medical Diagnostic Telemetry Data Transmission Protocol for Medical Sensors

Science.gov (United States)

Townsend, Ben; Abawajy, Jemal; Kim, Tai-Hoon

2011-01-01

People with special medical monitoring needs can, these days, be sent home and remotely monitored through the use of data logging medical sensors and a transmission base-station. While this can improve quality of life by allowing the patient to spend most of their time at home, most current technologies rely on hardwired landline technology or expensive mobile data transmissions to transmit data to a medical facility. The aim of this paper is to investigate and develop an approach to increase the freedom of a monitored patient and decrease costs by utilising mobile technologies and SMS messaging to transmit data from patient to medico. To this end, we evaluated the capabilities of SMS and propose a generic communications protocol which can work within the constraints of the SMS format, but provide the necessary redundancy and robustness to be used for the transmission of non-critical medical telemetry from data logging medical sensors. PMID:22163845

SMS-Based Medical Diagnostic Telemetry Data Transmission Protocol for Medical Sensors

Directory of Open Access Journals (Sweden)

Tai-Hoon Kim

2011-04-01

Full Text Available People with special medical monitoring needs can, these days, be sent home and remotely monitored through the use of data logging medical sensors and a transmission base-station. While this can improve quality of life by allowing the patient to spend most of their time at home, most current technologies rely on hardwired landline technology or expensive mobile data transmissions to transmit data to a medical facility. The aim of this paper is to investigate and develop an approach to increase the freedom of a monitored patient and decrease costs by utilising mobile technologies and SMS messaging to transmit data from patient to medico. To this end, we evaluated the capabilities of SMS and propose a generic communications protocol which can work within the constraints of the SMS format, but provide the necessary redundancy and robustness to be used for the transmission of non-critical medical telemetry from data logging medical sensors.

International exploration by independents

International Nuclear Information System (INIS)

Bertagne, R.G.

1992-01-01

Recent industry trends indicate that the smaller U.S. independents are looking at foreign exploration opportunities as one of the alternatives for growth in the new age of exploration. The problems of communications and logistics caused by different cultures and by geographic distances must be carefully evaluated. A mid-term to long-term strategy tailored to the goals and the financial capabilities of the company should be prepared and followed by a careful planning of the operations. This paper addresses some aspects of foreign exploration that should be considered before an independent venture into the foreign field. It also provides some guidelines for conducting successful overseas operations. When properly assessed, foreign exploration is well within the reach of smaller U.S. independents and presents no greater risk than domestic exploration; the rewards, however, can be much larger. Furthermore, the Oil and Gas Journal surveys of the 300 largest U.S. petroleum companies show that companies with a consistent foreign exploration policy have fared better financially during difficult times

Under the veil of neoliberalism: inequality, health, and capabilities

OpenAIRE

Kemp, Eagan

2008-01-01

The relationship between income inequality and health has received substantial attention in the fields of medical sociology and public health and continues to be debated. In Chile, previous findings indicate that there is an income inequality effect; respondents who live in areas with high inequality experience a greater probability of poor self-reported health. This study examines the Wilkinson income inequality hypothesis in a new way by using it in conjunction with Sen’s capability approac...

Professional identity in medical students: pedagogical challenges to medical education.

Science.gov (United States)

Wilson, Ian; Cowin, Leanne S; Johnson, Maree; Young, Helen

2013-01-01

Professional identity, or how a doctor thinks of himself or herself as a doctor, is considered to be as critical to medical education as the acquisition of skills and knowledge relevant to patient care. This article examines contemporary literature on the development of professional identity within medicine. Relevant theories of identity construction are explored and their application to medical education and pedagogical approaches to enhancing students' professional identity are proposed. The influence of communities of practice, role models, and narrative reflection within curricula are examined. Medical education needs to be responsive to changes in professional identity being generated from factors within medical student experiences and within contemporary society.

Leadership capabilities of physiotherapy leaders in Ireland: Part 1 physiotherapy managers.

Science.gov (United States)

McGowan, Emer; Elliott, Naomi; Stokes, Emma

2018-05-07

Investigation of the leadership capabilities of physiotherapists is needed to allow understanding of current leadership practice and to enable appropriate training programs to be developed. To explore physiotherapy managers´ perceptions of their leadership capabilities. Semi-structured interviews were conducted with a purposive sample of 18 physiotherapy managers from a range of public services and private practices in Ireland. The interviews were analyzed using template analysis and the coding template was based on the Bolman and Deal Leadership framework which details four leadership frames: structural, human resource, political, and symbolic. The physiotherapy managers described demonstrating leadership capabilities associated with each of the four leadership frames. However, the language used by the physiotherapy managers suggested that they work predominantly through the structural and human resource frames. The employment of capabilities associated with the political frame varied between participants; some participants described working through this frame while others reported difficulties. The symbolic frame was underused; there were fewer examples given of capabilities such as communicating their vision, demonstrating passion and facilitating a positive workplace culture. Physiotherapy managers work predominantly through the structural and human resource frames. To successfully meet the leadership requirements of their roles physiotherapy managers may benefit from specific leadership development training to develop leadership capabilities in the political and symbolic frames.

Architecture of firm dynamic capabilities across inter-organizational activities: Explaining innovativeness in the context of nanotechnology

Science.gov (United States)

Petricevic, Olga

In this dissertation I first develop a theoretical framework that explores different components of dynamic capabilities related to firm's boundary-spanning linkages across two different types of inter-organizational activities---alliances and networks. I argue that there are four different subsets of dynamic capabilities simultaneously at work: alliance opportunity-sensing, alliance opportunity-seizing, network opportunity-sensing and network opportunity-seizing. Furthermore, I argue that there are significant interaction effects between these distinctive subsets driving the firm's overall effectiveness in sensing and seizing of novel and innovative external opportunities. In order to explore potential interdependencies and draw distinctions among different dynamic capability subsets I integrate concepts from the two theoretical perspectives that often neglect the emphasis of the other---the dynamic capability view and the social network perspective. I then test the hypothesized relationships in the context of firms actively patenting in nanotechnology. Nanotechnology innovations are multidisciplinary in nature and require search and discovery across multiple inter-organizational, scientific, geographic, industry, or technological domains by a particular firm. The findings offer support for the conceptualizations of dynamic capabilities as consisting of distinct subsets of capabilities for the sensing and the seizing of external new-knowledge opportunities. The findings suggest that firm's innovativeness in an interdisciplinary scientific field such as nanotechnology is the function of the vector of multi-dimensional dynamic capabilities that are context-specific. Furthermore, the findings also suggest that there are inherent trade-offs embedded in different dimensions of dynamic capabilities when deployed across a wide range of inter-organizational relationships.

Relief for maritime medical emergencies through telematics.

Science.gov (United States)

Anogianakis, G; Maglavera, S; Pomportsis, A

1998-12-01

MERMAID is a European Union (EU)-financed maritime telemedicine project with global reach and 24-h multilingual capability, so as to serve multinational crews working in the isolation of the world's oceans. It provides a model for the provision of healthcare services based on the electronic transmission of medical information via ISDN-based video conferencing. This model is not limited to medical diagnostics, but it encompasses all cases in which the actual delivery of healthcare services involves a patient who is not located where the provider is. Its implementation requires the commissioning of an extensive telecommunications infrastructure that includes both satellite transmission for ship to shore communication and an extensive ground-based network for summoning expert medical help from around the world so as to meet the project's multilinguality requirements and, therefore, the exploration of a number of solutions. In fact, all categories of telemedical applications (audio and video conferencing, multimedia communications, flat file and image transfer with low-, medium-, and high-bandwidth data requirements) are considered, while the full range of network choices (digital land lines, cellular/wireless, satellite, and broadband) are being tested in terms of cost/performance tradeoffs that are inherent to them and the developmental stage each of these options occupies in their lifecycle. Finally, out of that, MERMAID utilizes advanced land-based line transmission technologies to aid the remote patient by making available the specialist care that is best suited in the particular case.

Organizational Context and Capabilities for Integrating Care: A Framework for Improvement

Directory of Open Access Journals (Sweden)

Jenna M. Evans

2016-08-01

Full Text Available Background: Interventions aimed at integrating care have become widespread in healthcare; however, there is significant variability in their success. Differences in organizational contexts and associated capabilities may be responsible for some of this variability. Purpose: This study develops and validates a conceptual framework of organizational capabilities for integrating care, identifies which of these capabilities may be most important, and explores the mechanisms by which they influence integrated care efforts.  Methods: The Context and Capabilities for Integrating Care (CCIC Framework was developed through a literature review, and revised and validated through interviews with leaders and care providers engaged in integrated care networks in Ontario, Canada. Interviews involved open-ended questions and graphic elicitation. Quantitative content analysis was used to summarize the data.  Results: The CCIC Framework consists of eighteen organizational factors in three categories: Basic Structures, People and Values, and Key Processes. The three most important capabilities shaping the capacity of organizations to implement integrated care interventions include Leadership Approach, Clinician Engagement and Leadership, and Readiness for Change. The majority of hypothesized relationships among organizational capabilities involved Readiness for Change and Partnering, emphasizing the complexity, interrelatedness and importance of these two factors to integrated care efforts.  Conclusions: Organizational leaders can use the framework to determine readiness to integrate care, develop targeted change management strategies, and select appropriate partners with overlapping or complementary profiles on key capabilities. Researchers may use the results to test and refine the proposed framework, with a focus on the hypothesized relationships among organizational capabilities and between organizational capabilities and performance outcomes.

Organizational Context and Capabilities for Integrating Care: A Framework for Improvement

Science.gov (United States)

Grudniewicz, Agnes; Baker, G. Ross; Wodchis, Walter P.

2016-01-01

Background: Interventions aimed at integrating care have become widespread in healthcare; however, there is significant variability in their success. Differences in organizational contexts and associated capabilities may be responsible for some of this variability. Purpose: This study develops and validates a conceptual framework of organizational capabilities for integrating care, identifies which of these capabilities may be most important, and explores the mechanisms by which they influence integrated care efforts. Methods: The Context and Capabilities for Integrating Care (CCIC) Framework was developed through a literature review, and revised and validated through interviews with leaders and care providers engaged in integrated care networks in Ontario, Canada. Interviews involved open-ended questions and graphic elicitation. Quantitative content analysis was used to summarize the data. Results: The CCIC Framework consists of eighteen organizational factors in three categories: Basic Structures, People and Values, and Key Processes. The three most important capabilities shaping the capacity of organizations to implement integrated care interventions include Leadership Approach, Clinician Engagement and Leadership, and Readiness for Change. The majority of hypothesized relationships among organizational capabilities involved Readiness for Change and Partnering, emphasizing the complexity, interrelatedness and importance of these two factors to integrated care efforts. Conclusions: Organizational leaders can use the framework to determine readiness to integrate care, develop targeted change management strategies, and select appropriate partners with overlapping or complementary profiles on key capabilities. Researchers may use the results to test and refine the proposed framework, with a focus on the hypothesized relationships among organizational capabilities and between organizational capabilities and performance outcomes. PMID:28413366

Managing the Innovators for Exploration and Exploitation

Directory of Open Access Journals (Sweden)

C. Annique UN

2007-09-01

Full Text Available I analyze how to manage employees to achieve a balance between exploration and exploitation in large established firms. Previous studies suggest that, although firms need to undertake both exploration and exploitation simultaneously, this is difficult either because of the scarcity of resources or because of the incompatibility of these two processes. Proposed solutions have been ambidexterity, punctuated equilibrium or specialization. I suggest another method: managing employees. Specifically, I argue that using the so-called “innovative” system of human resource management practices, consisting of team-based incentive system, team-based job design, and job rotation, enables the firm to undertake exploration and exploitation simultaneously because it provides the psychological safety for people to explore new knowledge to make novel products and develops employees to have the perspective-taking capability that enables the integration of knowledge cross-functionally for efficiency. Using the so-called “traditional” system of human resource management practices, consisting of individual-based incentive system, individual-based job design, and no job rotation, has limited impact on either exploration or exploitation because it does not create the psychological safety for people to explore new knowledge and does not develop the perspective-taking capability needed for exploitation. Moreover, mixing practices from both systems is better than only using the traditional system in achieving exploration or exploitation, but less effective than only using the innovative system as the mix of practices can create inconsistent expectations on employees.

Essential Medical Capabilities and Medical Readiness

Science.gov (United States)

2016-07-01

Bederman, S. S. et al. “The who, what and when of surgery for the degenerative lumbar spine: a population-based study of surgeon factors, surgical...injury, contusion 126 67 18 28 239 Spondylosis , intervertebral disc disorders, other back problems 50 92 35 20 197 Other fractures 75 30 0 55 160...190 5,068 Spondylosis , intervertebral disc disorders, other back problems 151 3,603 703 240 4,697 Sprains and strains 165 3,705 399 417 4,686

Critical medical humanities: embracing entanglement, taking risks.

Science.gov (United States)

Viney, William; Callard, Felicity; Woods, Angela

2015-06-01

What can the medical humanities achieve? This paper does not seek to define what is meant by the medical humanities, nor to adjudicate the exact disciplinary or interdisciplinary knowledges it should offer, but rather to consider what it might be capable of doing. Exploring the many valences of the word 'critical', we argue here for a critical medical humanities characterised by: (i) a widening of the sites and scales of 'the medical' beyond the primal scene of the clinical encounter; (ii) greater attention not simply to the context and experience of health and illness, but to their constitution at multiple levels; (iii) closer engagement with critical theory, queer and disability studies, activist politics and other allied fields; (iv) recognition that the arts, humanities and social sciences are best viewed not as in service or in opposition to the clinical and life sciences, but as productively entangled with a 'biomedical culture'; and, following on from this, (v) robust commitment to new forms of interdisciplinary and cross-sector collaboration. We go on to introduce the five other articles published in this special issue of the journal, reflecting on the ways in which collaboration and critique are articulated in their analyses of immunology, critical neuroscience, toxicity, global clinical labour, and psychological coercion and workfare. As these articles demonstrate, embracing the complex role of critical collaborator--one based on notions of entanglement, rather than servility or antagonism--will, we suggest, develop the imaginative and creative heterodox qualities and practices which have long been recognised as core strengths of the medical humanities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Gossiping Capabilities

DEFF Research Database (Denmark)

Mogensen, Martin; Frey, Davide; Guerraoui, Rachid

Gossip-based protocols are now acknowledged as a sound basis to implement collaborative high-bandwidth content dissemination: content location is disseminated through gossip, the actual contents being subsequently pulled. In this paper, we present HEAP, HEterogeneity Aware gossip Protocol, where...... nodes dynamically adjust their contribution to gossip dissemination according to their capabilities. Using a continuous, itself gossip-based, approximation of relative capabilities, HEAP dynamically leverages the most capable nodes by (a) increasing their fanouts (while decreasing by the same proportion...... declare a high capability in order to augment their perceived quality without contributing accordingly. We evaluate HEAP in the context of a video streaming application on a 236 PlanetLab nodes testbed. Our results shows that HEAP improves the quality of the streaming by 25% over a standard gossip...

[Exploration and analysis of the thought of medical education in the Shanghai New Chinese Medical College].

Science.gov (United States)

Li, Ming; Shang, Li; Bing, Shoulan

2014-11-01

Shanghai New Chinese Medical College set up by Zhu Nanshan and his sons, Zhu Xiaonan and Zhu Hegao, was a medical college of traditional Chinese medicine (TCM) with the most innovative spirit in modern time. Its affiliated research institute held the principle of "realizing the scientific truth of TCM, training TCM advanced talents", marking the beginning of the pioneering of "scientific TCM". The educational plan, clinical research and academic organization based on "carrying forward the quintessence of Chinese culture, absorbing and digesting the new knowledge" showed a certain influence at home and abroad. The College advocated the combination of communicating with famous physicians and the study of theory, cultivation of students' organization and academic society, launching of journals, and organizing students' research associations was aiming at the satisfaction of the social needs and teaching orientation. Its running experience provided useful reference for modern TCM medical education.

Analysis of the experience in participation of army medical service in medical arrangement in case of radiation accident

International Nuclear Information System (INIS)

Zhilyaev, E.G.; Goncharov, S.F.; Vorontsov, I.V.; Legeza, V.I.; Berzin, I.A.

1995-01-01

The paper presented calculations of manpower and money funds for rendering aid to the injured persons in case of radiation accident. The authors offered a scheme of using medical anti-radial aids on various stages of radiation accident; immediately after the accident in case of non-predicted and controlled radiation exposure. Army Medical Service is capable of solving promptly the tasks of medical aid with the help of highly mobile specialized medical units, the use of which is stipulated in the system of the Russian Service of disaster medicine. 10 refs.; 1 tab

Power capability prediction for lithium-ion batteries based on multiple constraints analysis

International Nuclear Information System (INIS)

Pan, Rui; Wang, Yujie; Zhang, Xu; Yang, Duo; Chen, Zonghai

2017-01-01

Highlights: • Multiple constraints for peak power capability prediction are deeply analyzed. • Multi-limited method is proposed for the peak power capability prediction of LIBs. • The EKF is used for the model based peak power capability prediction. • The FUDS and UDDS profiles are executed to evaluate the proposed method. - Abstract: The power capability of the lithium-ion battery is a key performance indicator for electric vehicle, and it is intimately correlated with the acceleration, regenerative braking and gradient climbing power requirements. Therefore, an accurate power capability or state-of-power prediction is critical to a battery management system, which can help the battery to work in suitable area and prevent the battery from over-charging and over-discharging. However, the power capability is easily affected by dynamic load, voltage variation and temperature. In this paper, three different constraints in power capability prediction are introduced, and the advantages and disadvantages of the three methods are deeply analyzed. Furthermore, a multi-limited approach for the power capability prediction is proposed, which can overcome the drawbacks of the three methods. Subsequently, the extended Kalman filter algorithm is employed for model based state-of-power prediction. In order to verify the proposed method, diverse experiments are executed to explore the efficiency, robustness, and precision. The results indicate that the proposed method can improve the precision and robustness obviously.

"It´s incredible how much I´ve had to fight." Negotiating medical uncertainty in clinical encounters.

Science.gov (United States)

Lian, Olaug S; Robson, Catherine

2017-01-01

Clinical encounters related to medically unexplained physical symptoms (MUPS) are associated with high levels of conflict between patients and doctors. Collaborative difficulties are fused by the medical uncertainty that dominates these consultations. The main aim of this study is to explore the interactional dynamics of clinical encounters riddled by medical uncertainty, as experienced by people living with long-term medically unexplained fatigue in Norway. A qualitative thematic analysis of written texts from 256 study participants. We found that patients experience being met with disbelief, inappropriate psychological explanations, marginalisation of experiences, disrespectful treatment, lack of physical examination and damaging health advice. The main source of their discontent is not the lack of biomedical knowledge, but doctors who fail to communicate acknowledgement of patients' experiences, knowledge and autonomy. War metaphors are emblematic of how participants describe their medical encounters. The overarching storyline depicts experiences of being caught in a power struggle with doctors and health systems, fused by a lack of common conceptual ground. When physical symptoms cannot be detected, explained and managed by biomedical knowledge and technology, good doctor-patient partnerships are crucial. Without clearly acknowledging patients' perspectives and capabilities in clinical practice, such partnerships cannot be achieved.

NASA Automated Fiber Placement Capabilities: Similar Systems, Complementary Purposes

Science.gov (United States)

Wu, K. Chauncey; Jackson, Justin R.; Pelham, Larry I.; Stewart, Brian K.

2015-01-01

New automated fiber placement systems at the NASA Langley Research Center and NASA Marshall Space Flight Center provide state-of-art composites capabilities to these organizations. These systems support basic and applied research at Langley, complementing large-scale manufacturing and technology development at Marshall. These systems each consist of a multi-degree of freedom mobility platform including a commercial robot, a commercial tool changer mechanism, a bespoke automated fiber placement end effector, a linear track, and a rotational tool support structure. In addition, new end effectors with advanced capabilities may be either bought or developed with partners in industry and academia to extend the functionality of these systems. These systems will be used to build large and small composite parts in support of the ongoing NASA Composites for Exploration Upper Stage Project later this year.

Rights, goals, and capabilities

NARCIS (Netherlands)

van Hees, M.V.B.P.M

This article analyses the relationship between rights and capabilities in order to get a better grasp of the kind of consequentialism that the capability theory represents. Capability rights have been defined as rights that have a capability as their object (rights to capabilities). Such a

Awareness of family medicine discipline among clinical medical ...

African Journals Online (AJOL)

Introduction: Undergraduate medical education requires the studying of a wide range of medical specialties to produce the future workforce of the healthcare system. Family medicine (FM), a relatively new specialty in Nigeria, aims at supplying doctors capable of providing comprehensive healthcare for the majority of the ...

Improving the Agency's Software Acquisition Capability

Science.gov (United States)

Hankinson, Allen

2003-01-01

External development of software has oftc n led to unsatisfactory results and great frustration for the assurE 7ce community. Contracts frequently omit critical assuranc 4 processes or the right to oversee software development activitie: At a time when NASA depends more and more on software to in plement critical system functions, combination of three factors ex; cerbate this problem: I ) the ever-increasing trend to acquire rather than develop software in-house, 2) the trend toward performance based contracts, and 3) acquisition vehicles that only state softwar 2 requirements while leaving development standards and assur! ince methodologies up to the contractor. We propose to identify specific methods at d tools that NASA projects can use to mitigate the adverse el ects of the three problems. TWO broad classes of methoddt ols will be explored. The first will be those that provide NASA p ojects with insight and oversight into contractors' activities. The st cond will be those that help projects objectively assess, and thus i nprwe, their software acquisition capability. Of particular interest is the Software Engineering Institute's (SEI) Software Acqt isition Capability Maturity Model (SA-CMMO).

Evaluating the Effects of Medical Explorers a Case Study Curriculum on Critical Thinking, Attitude Toward Life Science, and Motivational Learning Strategies in Rural High School Students

Science.gov (United States)

Brand, Lance G.

2011-12-01

The purpose of this study was three-fold: to measure the ability of the Medical Explorers case-based curriculum to improve higher order thinking skills; to evaluate the impact of the Medical Explorers case-based curriculum to help students be self directed learners; and to investigate the impact of the Medical Explorers case-based curriculum to improve student attitudes of the life sciences. The target population for this study was secondary students enrolled in advanced life science programs. The resulting sample (n = 71) consisted of 36 students in the case-based experimental group and 35 students in the control group. Furthermore, this study employed an experimental, pretest-posttest control group research design. The treatment consisted of two instructional strategies: case-based learning and teacher-guided learning. Analysis of covariance indicated no treatment effect on critical thinking ability or Motivation and Self-regulation of Learning. However, the Medical Explorers case-based curriculum did show a treatment effect on student attitudes toward the life sciences. These results seem to indicate that case-based curriculum has a positive impact on students' perspectives and attitudes about the study of life science as well as their interest in life science based careers. Such outcomes are also a good indicator that students enjoy and perceive the value to use of case studies in science, and because they see value in the work that they do they open up their minds to true learning and integration. Of additional interest was the observationthat on average eleventh graders showed consistently stronger gains in critical thinking, motivation and self-regulation of learning strategies, and attitudes toward the life sciences as compared to twelfth grade students. In fact, twelfth grade students showed a pre to post loss on the Watson-Glaser and the MSLQ scores while eleventh grade students showed positive gains on each of these instruments. This decline in twelfth

Creative Collaborative Exploration in Multiple Environments

DEFF Research Database (Denmark)

Overholt, Daniel; Turk, Matthew; Hollerer, Tobias

2008-01-01

We seek to support creativity in science, engineering, and design applications by building infrastructure that offers new capabilities for creative collaborative exploration of complex data in a variety of non-traditional computing environments. We describe particular novel environments and devic...

SPEX: The spectropolarimeter for planetary EXploration

NARCIS (Netherlands)

Snik, F.; Rietjens, J.H.H.; Harten, G. van; Stam, D.M.; Keller, C.U.; Smit, J.M.; Laan, E.C.; Verlaan, A.L.; Horst, R. ter; Navarro, R.; Wielinga, K.; Moon, S.G.; Voors, R.

2010-01-01

SPEX (Spectropolarimeter for Planetary EXploration) is an innovative, compact instrument for spectropolarimetry, and in particular for detecting and characterizing aerosols in planetary atmospheres. With its ∼1-liter volume it is capable of full linear spectropolarimetry, without moving parts. The

Does organizational agility affect organizational learning capability? Evidence from commercial banking

Directory of Open Access Journals (Sweden)

Zaina Mustafa Mahmoud Hamad

2017-08-01

Full Text Available Both organizational agility and learning capability are prerequisites for organizational survival and success. This study explores the contribution of agility practices to organizational learning capabilities at the commercial banks in Jordan. To examine the proposed model, a sample of 158 employees within top and middle managements was used. Structural Equation Modeling was conducted for assessing validity and reliability of measurement instrument, evaluating model fit, and testing hypotheses. This study recognizes agility as a key element of learning facilitators. Findings affirm the strategic value of agility and conclude that administrators working within ag-ile organizations would be able to acquire conditions that foster learning.

Telemedicine to Reduce Medical Risk in Austere Medical Environments: The Virtual Critical Care Consultation (VC3) Service.

Science.gov (United States)

Powell, Douglas; McLeroy, Robert D; Riesberg, Jamie; Vasios, William N; Miles, Ethan A; Dellavolpe, Jeffrey; Keenan, Sean; Pamplin, Jeremy C

One of the core capabilities of prolonged field care is telemedicine. We developed the Virtual Critical Care Consult (VC3) Service to provide Special Operations Forces (SOF) medics with on-demand, virtual consultation with experienced critical care physicians to optimize management and improve outcomes of complicated, critically injured or ill patients. Intensive-care doctors staff VC3 continuously. SOF medics access this service via phone or e-mail. A single phone call reaches an intensivist immediately. An e-mail distribution list is used to share information such as casualty images, vital signs flowsheet data, and short video clips, and helps maintain situational awareness among the VC3 critical care providers and other key SOF medical leaders. This real-time support enables direct communication between the remote provider and the clinical subject matter expert, thus facilitating expert management from near the point of injury until definitive care can be administered. The VC3 pilot program has been extensively tested in field training exercises and validated in several real-world encounters. It is an immediately available capability that can reduce medical risk and is scalable to all Special Operations Command forces. 2016.

Chat reference service in medical libraries: part 2--Trends in medical school libraries.

Science.gov (United States)

Dee, Cheryl R

2003-01-01

An increasing number of medical school libraries offer chat service to provide immediate, high quality information at the time and point of need to students, faculty, staff, and health care professionals. Part 2 of Chat Reference Service in Medical Libraries presents a snapshot of the current trends in chat reference service in medical school libraries. In late 2002, 25 (21%) medical school libraries provided chat reference. Trends in chat reference services in medical school libraries were compiled from an exploration of medical school library Web sites and informal correspondence from medical school library personnel. Many medical libraries are actively investigating and planning new chat reference services, while others have decided not to pursue chat reference at this time. Anecdotal comments from medical school library staff provide insights into chat reference service.

Exploring the experiences and coping strategies of international medical students

Directory of Open Access Journals (Sweden)

Malau-Aduli Bunmi S

2011-06-01

Full Text Available Abstract Background Few studies have addressed the challenges that international medical students face and there is a dearth of information on the behavioural strategies these students adopt to successfully progress through their academic program in the face of substantial difficulties of language barrier, curriculum overload, financial constraints and assessment tasks that require high proficiency in communication skills. Methods This study was designed primarily with the aim of enhancing understanding of the coping strategies, skill perceptions and knowledge of assessment expectations of international students as they progress through the third and fourth years of their medical degree at the School of Medicine, University of Tasmania, Australia. Results Survey, focus group discussion and individual interviews revealed that language barriers, communication skills, cultural differences, financial burdens, heavy workloads and discriminatory bottlenecks were key factors that hindered their adaptation to the Australian culture. Quantitative analyses of their examination results showed that there were highly significant (p Conclusions Despite the challenges, these students have adopted commendable coping strategies and progressed through the course largely due to their high sense of responsibility towards their family, their focus on the goal of graduating as medical doctors and their support networks. It was concluded that faculty needs to provide both academic and moral support to their international medical students at three major intervention points, namely point of entry, mid way through the course and at the end of the course to enhance their coping skills and academic progression. Finally, appropriate recommendations were made.

NASA Stennis Space Center Integrated System Health Management Test Bed and Development Capabilities

Science.gov (United States)

Figueroa, Fernando; Holland, Randy; Coote, David

2006-01-01

Integrated System Health Management (ISHM) is a capability that focuses on determining the condition (health) of every element in a complex System (detect anomalies, diagnose causes, prognosis of future anomalies), and provide data, information, and knowledge (DIaK)-not just data-to control systems for safe and effective operation. This capability is currently done by large teams of people, primarily from ground, but needs to be embedded on-board systems to a higher degree to enable NASA's new Exploration Mission (long term travel and stay in space), while increasing safety and decreasing life cycle costs of spacecraft (vehicles; platforms; bases or outposts; and ground test, launch, and processing operations). The topics related to this capability include: 1) ISHM Related News Articles; 2) ISHM Vision For Exploration; 3) Layers Representing How ISHM is Currently Performed; 4) ISHM Testbeds & Prototypes at NASA SSC; 5) ISHM Functional Capability Level (FCL); 6) ISHM Functional Capability Level (FCL) and Technology Readiness Level (TRL); 7) Core Elements: Capabilities Needed; 8) Core Elements; 9) Open Systems Architecture for Condition-Based Maintenance (OSA-CBM); 10) Core Elements: Architecture, taxonomy, and ontology (ATO) for DIaK management; 11) Core Elements: ATO for DIaK Management; 12) ISHM Architecture Physical Implementation; 13) Core Elements: Standards; 14) Systematic Implementation; 15) Sketch of Work Phasing; 16) Interrelationship Between Traditional Avionics Systems, Time Critical ISHM and Advanced ISHM; 17) Testbeds and On-Board ISHM; 18) Testbed Requirements: RETS AND ISS; 19) Sustainable Development and Validation Process; 20) Development of on-board ISHM; 21) Taxonomy/Ontology of Object Oriented Implementation; 22) ISHM Capability on the E1 Test Stand Hydraulic System; 23) Define Relationships to Embed Intelligence; 24) Intelligent Elements Physical and Virtual; 25) ISHM Testbeds and Prototypes at SSC Current Implementations; 26) Trailer

Enabling All-Access Mobility for Planetary Exploration Vehicles via Transformative Reconfiguration

Science.gov (United States)

Ferguson, Scott; Mazzoleni, Andre

2016-01-01

Effective large-scale exploration of planetary surfaces requires robotic vehicles capable of mobility across chaotic terrain. Characterized by a combination of ridges, cracks and valleys, the demands of this environment can cause spacecraft to experience significant reductions in operating footprint, performance, or even result in total system loss. Significantly increasing the scientific return of an interplanetary mission is facilitated by architectures capable of real-time configuration changes that go beyond that of active suspensions while concurrently meeting system, mass, power, and cost constraints. This Phase 1 report systematically explores how in-service architecture changes can expand system capabilities and mission opportunities. A foundation for concept generation is supplied by four Martian mission profiles spanning chasms, ice fields, craters and rocky terrain. A fifth mission profile centered on Near Earth Object exploration is also introduced. Concept generation is directed using four transformation principles - a taxonomy developed by the engineering design community to explain the cause of an architecture change and existing brainstorming techniques. This allowed early conceptual sketches of architecture changes to be organized by the principle driving the greatest increase in mission performance capability.

Capability ethics

NARCIS (Netherlands)

I.A.M. Robeyns (Ingrid)

2012-01-01

textabstractThe capability approach is one of the most recent additions to the landscape of normative theories in ethics and political philosophy. Yet in its present stage of development, the capability approach is not a full-blown normative theory, in contrast to utilitarianism, deontological

The desire and capability of Australian general practitioners to change their working hours.

Science.gov (United States)

Norman, Richard; Hall, Jane P

2014-04-21

To explore factors associated with general practitioners' desire to work less and their success in making that change. Waves 3 and 4 (conducted in 2010 and 2011) of a national longitudinal survey of Australian doctors in clinical practice (Medicine in Australia: Balancing Employment and Life). Of the broader group of medical practitioners in the survey, there were 3664 and 3436 GP completers in Waves 3 and 4, respectively. The association between the desire to reduce hours and doctor, job and geographic characteristics; the association between predictors of the capability to reduce hours and these same doctor, job and geographic characteristics. Over 40% of GPs stated a preference to reduce their working hours. Characteristics that predicted this preference were being middle-aged, being female, working ≥ 40 hours per week (all P working hours were being in excellent health, being satisfied or very satisfied with work (both P working hours, 26.8% successfully managed to do so in the subsequent year (where reduction was defined as reducing hours by at least 5 per week). Predictors of successfully reducing hours were being younger, female and working ≥ 40 hours per week (all P hours and their subsequent success in doing so. Declining working hours have contributed to the perceived shortage in GPs. Therefore, designing policies that address not just the absolute number of medical graduates but also their subsequent level of work may alleviate some of the pressures on the Australian primary health care system.

IMPROVEMENTS IN THE CAPABILITY PROFILE OF 3-D PRINTING: AN UPDATE

Directory of Open Access Journals (Sweden)

Dimitrov, Dimitar Marinov

2014-08-01

Full Text Available Knowledge about the capabilities of a production system is an important issue. The three- dimensional (3-D printing (drop-on-bed process has become a well-established Additive Manufacturing (AM technology. Initially intended for use mainly as a concept modeller, its scope of application has expanded to include, among others, fit and functional models, pattern-making for casting and moulding processes, rapid tooling, and medical and architectural models. This growth in applications has stimulated a reciprocal improvement in available materials and the technological capabilities of 3-D printing, such as accuracy, strength and elongation, surface finish, build time, and cost. These factors are of significance to users who want to control their processes better and to designers who want to define their expectations and determine their requirements. Thus this paper aims to provide a technical update, highlighting the influence level of different factors on a system’s capabilities. This paper uses the example of the ZPrinter 310 system from the Z Corporation, applies appropriate statistical techniques, and takes into consideration the latest material and machine developments, in order to report on the current improvements of the capability profile of this important process.

Shaping a Gender Equality Policy in Higher Education: Which Human Capabilities Matter?

Science.gov (United States)

Loots, Sonja; Walker, Melanie

2015-01-01

South African institutions still confront gendered inequalities, irrespective of transformative national policies, compounded by the absence of a national gender equality policy for higher education. We therefore explore the potential of the capabilities approach (CA) to inform policy formation and argue for the development of a policy for higher…

Dynamic Capabilities

DEFF Research Database (Denmark)

Grünbaum, Niels Nolsøe; Stenger, Marianne

2013-01-01

The findings reveal a positive relationship between dynamic capabilities and innovation performance in the case enterprises, as we would expect. It was, however, not possible to establish a positive relationship between innovation performance and profitability. Nor was there any positive...... relationship between dynamic capabilities and profitability....

Becoming an Educational Leader--Exploring Leadership in Medical Education

Science.gov (United States)

Bolander Laksov, Klara; Tomson, Tanja

2017-01-01

Research on educational leadership emphasizes the importance of having institutional leaders heavily involved with advanced instructional programming. Best practices for developing educational leadership in higher education health care and medical faculties have to be better understood. Within the framework of a seminar series, researchers and…

Exploring the consequences of combining medical students with and without a background in biomedical sciences.

Science.gov (United States)

Ellaway, Rachel H; Bates, Amanda; Girard, Suzanne; Buitenhuis, Deanna; Lee, Kyle; Warton, Aidan; Russell, Steve; Caines, Jill; Traficante, Eric; Graves, Lisa

2014-07-01

Medical schools have tended to admit students with strong backgrounds in the biomedical sciences. Previous studies have shown that those with backgrounds in the social sciences can be as successful in medical school as those with science backgrounds. However, the experience of being a 'non-science' student over time has not been well described. A mixed-methods study was developed and run with the aim of elucidating the personal experiences of science and non-science students at our institution. Data were generated from a student survey that focused on participants' self-identification as science or non-science students, and on their sense of preparedness and stress, and from a series of student focus groups exploring participants' experiences of science and non-science issues in all aspects of their training. Descriptive statistics were generated for structured survey data. Focus group data and unstructured survey data were analysed to identify common themes. End-of-module and end-of-year examination data for the four class cohorts in the programme were also analysed to compare science and non-science student performance over time. There were clear differences between the experiences and performance of science and non-science students. We found dichotomies in students' self-reported sense of preparedness and stress levels, and marked differences in their examination performance, which diminished over time to converge around the third year of their studies. Combining science and non-science students in the same class affected the students to different extents and in different ways. The potential disruption of mixing science and non-science students diminished as their levels of performance converged. The psychosocial stress experienced by non-science students and the challenges it posed, in both their academic and their personal lives, have implications for how such students should be supported, and how curricula can be configured to afford quality learning for all

Capabilities and Incapabilities of the Capabilities Approach to Health Justice.

Science.gov (United States)

Selgelid, Michael J

2016-01-01

This first part of this article critiques Sridhar Venkatapuram's conception of health as a capability. It argues that Venkatapuram relies on the problematic concept of dignity, implies that those who are unhealthy lack lives worthy of dignity (which seems politically incorrect), sets a low bar for health, appeals to metaphysically problematic thresholds, fails to draw clear connections between appealed-to capabilities and health, and downplays the importance/relevance of health functioning. It concludes by questioning whether justice entitlements should pertain to the capability for health versus health achievements, challenging Venkatapuram's claims about the strength of health entitlements, and demonstrating that the capabilities approach is unnecessary to address social determinants of health. © 2016 John Wiley & Sons Ltd.

Development and Demonstration of Sustainable Surface Infrastructure for Moon/Mars Exploration

Science.gov (United States)

Sanders, Gerald B.; Larson, William E.; Picard, Martin

2011-01-01

For long-term human exploration of the Moon and Mars to be practical, affordable, and sustainable, future missions must be able to identify and utilize resources at the site of exploration. The ability to characterize, extract, processes, and separate products from local material, known as In-Situ Resource Utilization (ISRU), can provide significant reductions in launch mass, logistics, and development costs while reducing risk through increased mission flexibility and protection as well as increased mission capabilities in the areas of power and transportation. Making mission critical consumables like propellants, fuel cell reagents and life support gases, as well as in-situ crew/hardware protection and energy storage capabilities can significantly enhance robotic and human science and exploration missions, however other mission systems need to be designed to interface with and utilize these in-situ developed products and services from the start or the benefits will be minimized or eliminated. This requires a level of surface and transportation system development coordination not typically utilized during early technology and system development activities. An approach being utilized by the US National Aeronautics and Space Administration and the Canadian Space Agency has been to utilize joint analogue field demonstrations to focus technology development activities to demonstrate and integrate new and potentially game changing. mission critical capabilities that would enable an affordable and sustainable surface infrastructure for lunar and Mars robotic and human exploration. Two analogue field tests performed in November 2008 and February 2010 demonstrated first generation capabilities for lunar resource prospecting, exploration site preparation, and oxygen extraction from regolith while initiating integration with mobility, science, fuel cell power, and propulsion disciplines. A third analogue field test currently planned for June 2012 will continue and expand

Emphasizing humanities in medical education: Promoting the integration of medical scientific spirit and medical humanistic spirit.

Science.gov (United States)

Song, Peipei; Tang, Wei

2017-05-23

In the era of the biological-psychological-social medicine model, an ideal of modern medicine is to enhance the humanities in medical education, to foster medical talents with humanistic spirit, and to promote the integration of scientific spirit and humanistic spirit in medicine. Throughout the United States (US), United Kingdom (UK), other Western countries, and some Asian countries like Japan, many medical universities have already integrated the learning of medical humanities in their curricula and recognized their value. While in China, although medical education reform over the past decade has emphasized the topic of medical humanities to increase the professionalism of future physicians, the integration of medical humanity courses in medical universities has lagged behind the pace in Western countries. In addition, current courses in medical humanities were arbitrarily established due to a lack of organizational independence. For various reasons like a shortage of instructors, medical universities have failed to pay sufficient attention to medical humanities education given the urgent needs of society. The medical problems in contemporary Chinese society are not solely the purview of biomedical technology; what matters more is enhancing the humanities in medical education and fostering medical talents with humanistic spirit. Emphasizing the humanities in medical education and promoting the integration of medical scientific spirit and medical humanistic spirit have become one of the most pressing issues China must address. Greater attention should be paid to reasonable integration of humanities into the medical curriculum, creation of medical courses related to humanities and optimization of the curriculum, and actively allocating abundant teaching resources and exploring better methods of instruction.

Medical students' agenda-setting abilities during medical interviews.

Science.gov (United States)

Roh, HyeRin; Park, Kyung Hye; Jeon, Young-Jee; Park, Seung Guk; Lee, Jungsun

2015-06-01

Identifying patients' agendas is important; however, the extent of Korean medical students' agenda-setting abilities is unknown. The study aim was to investigate the patterns of Korean medical students' agenda solicitation. A total of 94 third-year medical students participated. One scenario involving a female patient with abdominal pain was created. Students were video-recorded as they interviewed the patient. To analyze whether students identify patients' reasons for visiting, a checklist was developed based on a modified version of the Calgary-Cambridge Guide to the Medical Interview: Communication Process checklist. The duration of the patient's initial statement of concerns was measured in seconds. The total number of patient concerns expressed before interruption and the types of interruption effected by the medical students were determined. The medical students did not explore the patients' concerns and did not negotiate an agenda. Interruption of the patient's opening statement occurred in 4.62±2.20 seconds. The most common type of initial interruption was a recompleter (79.8%). Closed-ended questions were the most common question type in the second and third interruptions. Agenda setting should be emphasized in the communication skills curriculum of medical students. The Korean Clinical Skills Exam must assess medical students' ability to set an agenda.

Medical Diplomacy: A Tool for Enabling National Security Strategy Objectives

Science.gov (United States)

2012-04-06

USGs global health portfolio includes a diverse set of programs and investments in...cultural linguistic competency, expertise in regional medical initiatives, and knowledge of joint coordination in the ability foster medical goodwill...operates medical research units in Egypt and Peru . Additionally, the Navy has operated facilities in Indonesia and maintains research capabilities

Medical simulator with injection device

NARCIS (Netherlands)

2011-01-01

medical simulator 611 comprises a vessel 609 representing a simulated blood vessel. The vessel comprises a simulated vessel wall capable of being punctured by an electrically conductive injection needle 503. The vessel wall comprises a first electrically conductive layer for closing an electric

Power and the teaching of medical ethics.

OpenAIRE

Nicholas, B

1999-01-01

This paper argues that ethics education needs to become more reflective about its social and political ethic as it participates in the construction and transmission of medical ethics. It argues for a critical approach to medical ethics and explores the political context in medical schools and some of the peculiar problems in medical ethics education.

An exploration into the awareness and perceptions of medical ...

African Journals Online (AJOL)

effect on how patients present to healthcare providers.[1] Such ... Focus group discussions were conducted with final-year medical students in the Family Medicine rotation. ... and patients in cross-cultural consultations, the potential knowledge and experience gap that exists across cultures, and an awareness of the need for.

Non-medical influences on medical decision-making.

Science.gov (United States)

McKinlay, J B; Potter, D A; Feldman, H A

1996-03-01

The influence of non-medical factors on physicians' decision-making has been documented in many observational studies, but rarely in an experimental setting capable of demonstrating cause and effect. We conducted a controlled factorial experiment to assess the influence of non-medical factors on the diagnostic and treatment decisions made by practitioners of internal medicine in two common medical situations. One hundred and ninety-two white male internists individually viewed professionally produced video scenarios in which the actor-patient, presenting with either chest pain or dyspnea, possessed various balanced combinations of sex, race, age, socioeconomic status, and health insurance coverage. Physician subjects were randomly drawn from lists of internists in private practice, hospital-based practice, and HMO's, at two levels of experience. The most frequent diagnoses for both chest pain and dyspnea were psychogenic origin and cardiac problems. Smoking cessation was the most frequent treatment recommendation for both conditions. Younger patients (all other factors being the same) were significantly more likely to receive the psychogenic diagnosis. Older patients were more likely to receive the cardiac diagnosis for chest pain, particularly if they were insured. HMO-based physicians were more likely to recommend a follow-up visit for chest pain. Several interactions of patient and physician factors were significant in addition to the main effects. The variability in decision-making evidenced by physicians in this experiment was not entirely accounted for by strictly rational Bayesian inference (the common prescriptive model for medical decision-making), in-as-much as non-medical factors significantly affected the decisions that they made. There is a need to supplement idealized medical schemata with considerations of social behavior in any comprehensive theory of medical decision-making.

Development of a SERS aptasensor for detection of medical residues

DEFF Research Database (Denmark)

Frøhling, Kasper Bayer

Low levels of medical residues in environmental, industrial and domestic water systems is a growing concern. The biosensor industry is trying to accomodate the need of sensitive and specific sensor systems capable of ultra-low level detection of medical residues. In this PhD project a surface...... for sensitive and selective capture of medical residues....

Space Launch System for Exploration and Science

Science.gov (United States)

Klaus, K.

2013-12-01

Introduction: The Space Launch System (SLS) is the most powerful rocket ever built and provides a critical heavy-lift launch capability enabling diverse deep space missions. The exploration class vehicle launches larger payloads farther in our solar system and faster than ever before. The vehicle's 5 m to 10 m fairing allows utilization of existing systems which reduces development risks, size limitations and cost. SLS lift capacity and superior performance shortens mission travel time. Enhanced capabilities enable a myriad of missions including human exploration, planetary science, astrophysics, heliophysics, planetary defense and commercial space exploration endeavors. Human Exploration: SLS is the first heavy-lift launch vehicle capable of transporting crews beyond low Earth orbit in over four decades. Its design maximizes use of common elements and heritage hardware to provide a low-risk, affordable system that meets Orion mission requirements. SLS provides a safe and sustainable deep space pathway to Mars in support of NASA's human spaceflight mission objectives. The SLS enables the launch of large gateway elements beyond the moon. Leveraging a low-energy transfer that reduces required propellant mass, components are then brought back to a desired cislunar destination. SLS provides a significant mass margin that can be used for additional consumables or a secondary payloads. SLS lowers risks for the Asteroid Retrieval Mission by reducing mission time and improving mass margin. SLS lift capacity allows for additional propellant enabling a shorter return or the delivery of a secondary payload, such as gateway component to cislunar space. SLS enables human return to the moon. The intermediate SLS capability allows both crew and cargo to fly to translunar orbit at the same time which will simplify mission design and reduce launch costs. Science Missions: A single SLS launch to Mars will enable sample collection at multiple, geographically dispersed locations and a

A systematic review on perceptual-motor calibration to changes in action capabilities.

Science.gov (United States)

van Andel, Steven; Cole, Michael H; Pepping, Gert-Jan

2017-01-01

Perceptual-motor calibration has been described as a mapping between perception and action, which is relevant to distinguish possible from impossible opportunities for action. To avoid movement errors, it is relevant to rapidly calibrate to immediate changes in capabilities and therefore this study sought to explain in what conditions calibration is most efficient. A systematic search of seven databases was conducted to identify literature concerning changes in calibration in response to changes in action capabilities. Twenty-three papers satisfied the inclusion criteria. Data revealed that calibration occurs rapidly if there is a good match between the task that requires calibration and the sources of perceptual-motor information available for exploration (e.g. when exploring maximal braking capabilities by experiencing braking). Calibration can take more time when the perceptual-motor information that is available is less relevant. The current study identified a number of limitations in the field of perceptual-motor research. Most notably, the mean participant age in the included studies was between 18 and 33years of age, limiting the generalizability of the results to other age groups. Also, due to inconsistent terminology used in the field of perceptual-motor research, we argue that investigating calibration in older cohorts should be a focus of future research because of the possible implications of impaired calibration in an aging society. Copyright © 2016 Elsevier B.V. All rights reserved.

An exploration into the awareness and perceptions of medical ...

African Journals Online (AJOL)

factors in a multicultural society influence the consultation, and to suggest adaptations for teaching. Methods. Focus group discussions were conducted with final-year medical students in the Family Medicine rotation. Some of the students had viewed a video of a consultation with an isiZulu-speaking patient, and completed ...

Health capabilities and diabetes self-management: the impact of economic, social, and cultural resources.

Science.gov (United States)

Weaver, Robert R; Lemonde, Manon; Payman, Naghmeh; Goodman, William M

2014-02-01

While the "social determinants of health" view compels us to explore how social structures shape health outcomes, it often ignores the role individual agency plays. In contrast, approaches that focus on individual choice and personal responsibility for health often overlook the influence of social structures. Amartya Sen's "capabilities" framework and its derivative the "health capabilities" (HC) approach attempts to accommodate both points of view, acknowledging that individuals function under social conditions over which they have little control, while also acting as agents in their own health and well-being. This paper explores how economic, social, and cultural resources shape the health capability of people with diabetes, focusing specifically on dietary practices. Health capability and agency are central to dietary practices, while also being shaped by immediate and broader social conditions that can generate habits and a lifestyle that constrain dietary behaviors. From January 2011 to December 2012, we interviewed 45 people with diabetes from a primary care clinic in Ontario (Canada) to examine how their economic, social, and cultural resources combine to influence dietary practices relative to their condition. We classified respondents into low, medium, and high resource groups based on economic circumstances, and compared how economic resources, social relationships, health-related knowledge and values combine to enhance or weaken health capability and dietary management. Economic, social, and cultural resources conspired to undermine dietary management among most in the low resource group, whereas social influences significantly influenced diet among many in the medium group. High resource respondents appeared most motivated to maintain a healthy diet, and also had the social and cultural resources to enable them to do so. Understanding the influence of all three types of resources is critical for constructing ways to enhance health capability, chronic

The Value of Humans in the Biological Exploration of Space

Science.gov (United States)

Cockell, C. S.

2004-06-01

Regardless of the discovery of life on Mars, or of "no apparent life" on Mars, the questions that follow will provide a rich future for biological exploration. Extraordinary pattern recognition skills, decadal assimilation of data and experience, and rapid sample acquisition are just three of the characteristics that make humans the best means we have to explore the biological potential of Mars and other planetary surfaces. I make the case that instead of seeing robots as in conflict, or even in support, of human exploration activity, from the point of view of scientific data gathering and analysis, we should view humans as the most powerful robots we have, thus removing the separation that dogs discussions on the exploration of space. The narrow environmental requirements of humans, although imposing constraints on the life support systems required, is more than compensated for by their capabilities in biological exploration. I support this view with an example of the "Christmas present effect," a simple demonstration of human data and pattern recognition capabilities.

Smartphone-based biosensing platform evolution: implementation of electrochemical analysis capabilities

DEFF Research Database (Denmark)

Patou, François; Dimaki, Maria; Svendsen, Winnie Edith

2016-01-01

Lab-on-Chip technologies offer great opportunities for the democratization of in-vitro medical diagnostics to the consumer-market. Despite the limitations set by the strict instrumentation and control requirements of certain families of these devices, new solutions are emerging. Smartphones now...... routinely demonstrate their potential as an interface of choice for operating complex, instrumented Lab-on-Chips. The sporadic nature of home-based in-vitro medical diagnostics testing calls for the development of systems capable of evolving with new applications or new technologies for Lab-on-Chip devices....... We present in this work how we evolved the first generation of a smartphone/Lab-on-Chip platform designed for evolvability. We demonstrate how reengineering efforts can be confined to the mobile-software layer and illustrate some of the benefits of building evolvable systems. We implement...

Performance Analysis of the Capability Assessment Tool for Sustainable Manufacturing

Directory of Open Access Journals (Sweden)

Enda Crossin

2013-08-01

Full Text Available This paper explores the performance of a novel capability assessment tool, developed to identify capability gaps and associated training and development requirements across the supply chain for environmentally-sustainable manufacturing. The tool was developed to assess 170 capabilities that have been clustered with respect to key areas of concern such as managing energy, water, material resources, carbon emissions and waste as well as environmental management practices for sustainability. Two independent expert teams used the tool to assess a sample group of five first and second tier sports apparel and footwear suppliers within the supply chain of a global sporting goods manufacturer in Asia. The paper addresses the reliability and robustness of the developed assessment method by formulating the expected links between the assessment results. The management practices of the participating suppliers were shown to be closely connected to their performance in managing their resources and emissions. The companies’ initiatives in implementing energy efficiency measures were found to be generally related to their performance in carbon emissions management. The suppliers were also asked to undertake a self-assessment by using a short questionnaire. The large gap between the comprehensive assessment and these in-house self-assessments revealed the suppliers’ misconceptions about their capabilities.

Anaphylaxis, Intra-Abdominal Infections, Skin Lacerations, and Behavioral Emergencies: A Literature Review of Austere Analogs for a near Earth Asteroid Mission

Science.gov (United States)

Chough, Natacha G.; Watkins, Sharmi; Menon, Anil S.

2012-01-01

As space exploration is directed towards destinations beyond low-Earth orbit, the consequent new set of medical risks will drive requirements for new capabilities and more resources to ensure crew health. The Space Medicine Exploration Medical Conditions List (SMEMCL), developed by the Exploration Medical Capability element of the Human Research Program, addresses the risk of "unacceptable health and mission outcomes due to limitations of in-flight medical capabilities". It itemizes 85 evidence-based clinical requirements for eight different mission profiles and identifies conditions warranting further research and technology development. Each condition is given a clinical priority for each mission profile. Four conditions -- intra-abdominal infections, skin lacerations, anaphylaxis, and behavioral emergencies -- were selected as a starting point for analysis. A systematic literature review was performed to understand how these conditions are treated in austere, limited-resource, space-analog environments (i.e., high-altitude and mountain environments, submarines, military deployments, Antarctica, isolated wilderness environments, in-flight environments, and remote, resource-poor, rural environments). These environments serve as analogs to spaceflight because of their shared characteristics (limited medical resources, delay in communication, confined living quarters, difficulty with resupply, variable time to evacuation). Treatment of these four medical conditions in austere environments provides insight into medical equipment and training requirements for exploration-class missions.

Empathy in Medical Students: Exploring the Impact of a Longitudinal Integrated Clerkship Model

Science.gov (United States)

Bergstresser, Kara

2017-01-01

Empathy is considered a significant factor in the physician-patient relationship. The current study examined the impact of a Longitudinal Integrated Clerkship (LIC) model on empathy and patient-centered attitude in medical students. Archival data were examined from 186 medical students at a medical college in the mid-Atlantic region of the United…

Cross-Sector Partnerships and the Co-creation of Dynamic Capabilities for Stakeholder Orientation

NARCIS (Netherlands)

Dentoni, D.; Bitzer, V.C.; Pascucci, S.

2016-01-01

This paper explores the relationship between business experience in cross-sector partnerships (CSPs) and the co-creation of what we refer to as ‘dynamic capabilities for stakeholder orientation,’ consisting of the four dimensions of (1) sensing, (2) interacting with, (3) learning from and (4)

Exploring digital professionalism.

Science.gov (United States)

Ellaway, Rachel H; Coral, Janet; Topps, David; Topps, Maureen

2015-01-01

The widespread use of digital media (both computing devices and the services they access) has blurred the boundaries between our personal and professional lives. Contemporary students are the last to remember a time before the widespread use of the Internet and they will be the first to practice in a largely e-health environment. This article explores concepts of digital professionalism and their place in contemporary medical education, and proposes a series of principles of digital professionalism to guide teaching, learning and practice in the healthcare professions. Despite the many risks and fears surrounding their use, digital media are not an intrinsic threat to medical professionalism. Professionals should maintain the capacity for deliberate, ethical, and accountable practice when using digital media. The authors describe a digital professionalism framework structured around concepts of proficiency, reputation, and responsibility. Digital professionalism can be integrated into medical education using strategies based on awareness, alignment, assessment, and accountability. These principles of digital professionalism provide a way for medical students and medical practitioners to embrace the positive aspects of digital media use while being mindful and deliberate in its use to avoid or minimize any negative consequences.

Interactive data language (IDL) for medical image processing

International Nuclear Information System (INIS)

Md Saion Salikin

2002-01-01

Interactive Data Language (IDL) is one of many softwares available in the market for medical image processing and analysis. IDL is a complete, structured language that can be used both interactively and to create sophisticated functions, procedures, and applications. It provides a suitable processing routines and display method which include animation, specification of colour table including 24-bit capability, 3-D visualization and many graphic operation. The important features of IDL for medical imaging are segmentation, visualization, quantification and pattern recognition. In visualization IDL is capable of allowing greater precision and flexibility when visualizing data. For example, IDL eliminates the limits on Number of Contour level. In term of data analysis, IDL is capable of handling complicated functions such as Fast Fourier Transform (FFT) function, Hough and Radon Transform function, Legendre Polynomial function, as well as simple functions such as Histogram function. In pattern recognition, pattern description is defined as points rather than pixels. With this functionality, it is easy to re-use the same pattern on more than one destination device (even if the destinations have varying resolution). In other words it have the ability to specify values in points. However there are a few disadvantages of using IDL. Licensing is by dongkel key and limited licences hence limited access to potential IDL users. A few examples are shown to demonstrate the capabilities of IDL in carrying out its function for medical image processing. (Author)

Dose reconstruction modeling for medical radiation workers

International Nuclear Information System (INIS)

Choi, Yeong Chull; Cha, Eun Shil; Lee, Won Jin

2017-01-01

Exposure information is a crucial element for the assessment of health risk due to radiation. Radiation doses received by medical radiation workers have been collected and maintained by public registry since 1996. Since exposure levels in the remote past are greater concern, it is essential to reconstruct unmeasured doses in the past using known information. We developed retrodiction models for different groups of medical radiation workers and estimate individual past doses before 1996. Reconstruction models for past radiation doses received by medical radiation workers were developed, and the past doses were estimated. Using these estimates, organ doses should be calculated which, in turn, will be used to explore a wide range of health risks of medical occupational radiation exposure. Reconstruction models for past radiation doses received by medical radiation workers were developed, and the past doses were estimated. Using these estimates, organ doses should be calculated which, in turn, will be used to explore a wide range of health risks of medical occupational radiation exposure.

Dose reconstruction modeling for medical radiation workers

Energy Technology Data Exchange (ETDEWEB)

Choi, Yeong Chull; Cha, Eun Shil; Lee, Won Jin [Dept. of Preventive Medicine, Korea University, Seoul (Korea, Republic of)

2017-04-15

Exposure information is a crucial element for the assessment of health risk due to radiation. Radiation doses received by medical radiation workers have been collected and maintained by public registry since 1996. Since exposure levels in the remote past are greater concern, it is essential to reconstruct unmeasured doses in the past using known information. We developed retrodiction models for different groups of medical radiation workers and estimate individual past doses before 1996. Reconstruction models for past radiation doses received by medical radiation workers were developed, and the past doses were estimated. Using these estimates, organ doses should be calculated which, in turn, will be used to explore a wide range of health risks of medical occupational radiation exposure. Reconstruction models for past radiation doses received by medical radiation workers were developed, and the past doses were estimated. Using these estimates, organ doses should be calculated which, in turn, will be used to explore a wide range of health risks of medical occupational radiation exposure.

The Advanced Modeling, Simulation and Analysis Capability Roadmap Vision for Engineering

Science.gov (United States)

Zang, Thomas; Lieber, Mike; Norton, Charles; Fucik, Karen

2006-01-01

This paper summarizes a subset of the Advanced Modeling Simulation and Analysis (AMSA) Capability Roadmap that was developed for NASA in 2005. The AMSA Capability Roadmap Team was chartered to "To identify what is needed to enhance NASA's capabilities to produce leading-edge exploration and science missions by improving engineering system development, operations, and science understanding through broad application of advanced modeling, simulation and analysis techniques." The AMSA roadmap stressed the need for integration, not just within the science, engineering and operations domains themselves, but also across these domains. Here we discuss the roadmap element pertaining to integration within the engineering domain, with a particular focus on implications for future observatory missions. The AMSA products supporting the system engineering function are mission information, bounds on information quality, and system validation guidance. The Engineering roadmap element contains 5 sub-elements: (1) Large-Scale Systems Models, (2) Anomalous Behavior Models, (3) advanced Uncertainty Models, (4) Virtual Testing Models, and (5) space-based Robotics Manufacture and Servicing Models.

The Role 1 capability review: mitigation and innovation for Op HERRICK 18 and into contingency.

Science.gov (United States)

Wheatley, Robert J

2014-09-01

The Role 1 orientated JRAMC of September 2012 was a welcome addition to the body of Role 1 literature. In particular, the Role 1 capability review by Hodgetts and Findlay detailed both current issues and future aspirations for Role 1 provision. This personal view considers issues still prevalent during Op HERRICK 18 namely the provision of primary healthcare by combat medical technicians on operations and the organisational issues that contribute to historical structural and attitudinal obstructions to the employment of combat medical technicians in firm base primary healthcare. It also considers a dynamically updating dashboard capable of displaying risk across the Role 1 network with the implied move to a model of continuous healthcare assurance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A PERSPECTIVE ON MILITARY MEDICAL SERVICE ROLE IN STABILIZATION OPERATIONS: EXPANSION OF AIR FORCE MEDICAL SERVICE CAPABILITIES INMEDICAL DIPLOMACY

Science.gov (United States)

2017-04-06

global and regional international organizations (IOs), US and foreign nongovernmental organizations ( NGOs ), and private-sector individuals and for-profit...iv Abstract This research paper advocates that the US military health workers will be more effective in medical diplomacy than their NGO ...organizations (IO), and non-governmental organizations ( NGO ), provided humanitarian assistance to bring social stability to affected regions. In

Existing and new techniques in uranium exploration

International Nuclear Information System (INIS)

Bowie, S.H.U.; Cameron, J.

1976-01-01

The demands on uranium exploration over the next 25 years will be very great indeed and will call for every possible means of improvement in exploration capability. The first essential is to increase geological knowledge of the mode of occurrence of uranium ore deposits. The second is to improve existing exploration techniques and instrumentation while, at the same time, promoting research and development on new methods to discover uranium ore bodies on the earth's surface and at depth. The present symposium is an effort to increase co-operation and the exchange of information in the critical field of uranium exploration techniques and instrumentation. As an introduction to the symposium a brief review is presented, firstly of what can be considered as existing techniques and, secondly, of techniques which have not yet been used on an appreciable scale. Some fourteen techniques used over the last 30 years are identified and their appropriate application, advantages and limitations are briefly summarized and the possibilities of their further development considered. The aim of future research on new techniques, in addition to finding new ways and means of identifying surface deposits, should be mainly directed to devising methods and instrumentation capable of detecting buried ore bodies that do not give a gamma signal at the surface. To achieve this aim, two contributory factors are essential: adequate financial support for research and development and increased specialized training in uranium exploration and instrumentation design. The papers in this symposium describe developments in the existing techniques, proposals for future research and development and case histories of exploration programmes

Exploring the beliefs underlying attitudes to active voluntary euthanasia in a sample of Australian medical practitioners and nurses: a qualitative analysis.

Science.gov (United States)

White, Katherine M; Wise, Susi E; Young, Ross McD; Hyde, Melissa K

A qualitative study explored beliefs about active voluntary euthanasia (AVE) in a sample (N = 18) of medical practitioners and nurses from Australia, where AVE is not currently legal. Four behaviors relating to AVE emerged during the interviews: requesting euthanasia for oneself, legalizing AVE, administering AVE to patients if it were legalized, and discussing AVE with patients if they request it. Using thematic analysis, interviews were analyzed for beliefs related to advantages and disadvantages of performing these AVE behaviors. Medical practitioners and nurses identified a number of similar benefits for performing the AVE-related behaviors, both for themselves personally and as health professionals. Benefits also included a consideration of the positive impact for patients, their families, and the health care system. Disadvantages across behaviors focused on the potential conflict between those parties involved in the decision making process, as well as conflict between one's own personal and professional values.

Missile Defense in the 21st Century Acquisition Environment: Exploring a BMD-Capable LCS Mission Package

Science.gov (United States)

2013-09-01

BDA ) to the operator REQ.1.2.3 The system shall provide post mission data at the end of mission REQ.1.2.4 The system shall has the capability...sheet 6 — The beaufort scale. Retrieved from National Meteorological Library and Archive: http://www.metoffice.gov.uk/ media /pdf/b/7/Fact_sheet_No._6

Bullying among medical students in a Saudi medical school

Directory of Open Access Journals (Sweden)

Alzahrani Hasan

2012-07-01

Full Text Available Abstract Background Bullying and sexual harassment of medical students by their teachers appears to be widespread phenomenon. However, nothing is published about its prevalence in conservative countries such as Saudi Arabia. This survey aims to ascertain the extent of these mistreatments among students in a Saudi medical school. Findings A cross-sectional questionnaire survey was conducted on a group of 542 clinical years’ medical students in a Saudi medical school to explore students' perceptions of their educational environment including exposure to different kinds of bullying. Bullying was defined as “a “persistent behaviour against a medical student that is intimidating, degrading, offensive or malicious and undermines the confidence and self- esteem of the recipient”. Results revealed that more than one quarter (28.0% of the surveyed students reported exposure to some sort of bullying during their clinical. Ninety percent of the reported insults were verbal, 6% sexual and 4% physical. Males were more exposed but difference was not statistically significant. Conclusions Bullying among Saudi medical students is an existing problem. A policy against bullying and harassment should be adopted in all of medical colleges to monitor this phenomenon and support students who have been bullied.

Capability-based computer systems

CERN Document Server

Levy, Henry M

2014-01-01

Capability-Based Computer Systems focuses on computer programs and their capabilities. The text first elaborates capability- and object-based system concepts, including capability-based systems, object-based approach, and summary. The book then describes early descriptor architectures and explains the Burroughs B5000, Rice University Computer, and Basic Language Machine. The text also focuses on early capability architectures. Dennis and Van Horn's Supervisor; CAL-TSS System; MIT PDP-1 Timesharing System; and Chicago Magic Number Machine are discussed. The book then describes Plessey System 25

Medical school personal statements: a measure of motivation or proxy for cultural privilege?

Science.gov (United States)

Wright, Sarah

2015-08-01

Students from state schools are underrepresented in UK medical schools. Discussions often focus on deficient academic and motivational traits of state school students, rather than considering the effects of student support during the admissions process. This qualitative study explored student experiences of support from schools and families during the medical school admissions process with particular focus on the personal statement. Interviews were conducted with thirteen medical students at a British medical school who had each attended a different secondary school (classified as private or state funded). A thematic analysis was performed. Bourdieu's concepts of capital and field were used as a theoretical lens through which to view the results. Interviews revealed substantial differences in support provided by private and state funded schools. Private schools had much more experience in the field of medical school admissions and had a vested interest in providing students with support. State schools were lacking by comparison, offering limited support that was often reactive rather than proactive. Students from private schools were also more likely to have social contacts who were knowledgeable about medical school admissions and who could help them gain access to work experience opportunities that would be recognised as legitimate by selectors. While medical schools endeavour to make fair admissions policies, there is an unintended link between a student's access to capital and ability to demonstrate commitment and motivation on personal statements. This helps explain why academically capable but financially or socially challenged students are less likely to be recognised as having potential during the admissions process. Medical schools need to be challenged to review their admissions policies to ensure that the do not inadvertently favour cultural privilege rather than student potential.

Mobile Test Capabilities

Data.gov (United States)

Federal Laboratory Consortium — The Electrical Power Mobile Test capabilities are utilized to conduct electrical power quality testing on aircraft and helicopters. This capability allows that the...

National Aeronautics and Space Administration Exploration Systems Interim Strategy

Science.gov (United States)

2004-01-01

Contents include the following: 1. The Exploration Systems Mission Directorate within NASA. Enabling the Vision for Space Exploration. The Role of the Directorate. 2. Strategic Context and Approach. Corporate Focus. Focused, Prioritized Requirements. Spiral Transformation. Management Rigor. 3. Achieving Directorate Objectives. Strategy to Task Process. Capability Development. Research and Technology Development. 4. Beyond the Horizon. Appendices.

Mars Surface Systems Common Capabilities and Challenges for Human Missions

Science.gov (United States)

Toups, Larry; Hoffman, Stephen J.

2016-01-01

This paper describes the current status of common systems and operations as they are applied to actual locations on Mars that are representative of Exploration Zones (EZ) - NASA's term for candidate locations where humans could land, live and work on the Martian surface. Given NASA's current concepts for human missions to Mars, an EZ is a collection of Regions of Interest (ROIs) located within approximately 100 kilometers of a centralized landing site. ROIs are areas that are relevant for scientific investigation and/or development/maturation of capabilities and resources necessary for a sustainable human presence. An EZ also contains a habitation site that will be used by multiple human crews during missions to explore and utilize the ROIs within the EZ. The Evolvable Mars Campaign (EMC), a description of NASA's current approach to these human Mars missions, assumes that a single EZ will be identified within which NASA will establish a substantial and durable surface infrastructure that will be used by multiple human crews. The process of identifying and eventually selecting this single EZ will likely take many years to finalized. Because of this extended EZ selection process it becomes important to evaluate the current suite of surface systems and operations being evaluated for the EMC as they are likely to perform at a variety of proposed EZ locations and for the types of operations - both scientific and development - that are proposed for these candidate EZs. It is also important to evaluate proposed EZs for their suitability to be explored or developed given the range of capabilities and constraints for the types of surface systems and operations being considered within the EMC. Four locations identified in the Mars Exploration Program Analysis Group (MEPAG)'s Human Exploration of Mars Science Analysis Group (HEM-SAG) report are used in this paper as representative of candidate EZs that will emerge from the selection process that NASA has initiated. A field

Exploring the Case for a Global Alliance for Medical Diagnostics Initiative

Directory of Open Access Journals (Sweden)

Melissa L. Mugambi

2017-01-01

Full Text Available In recent years, the private and public sectors have increased investments in medical diagnostics for low- and middle-income countries (LMICs. Despite these investments, numerous barriers prevent the adoption of existing diagnostics and discourage the development and introduction of new diagnostics in LMICs. In the late 1990s, the global vaccine community had similar challenges, as vaccine coverage rates stagnated and the introduction of new vaccines was viewed as a distraction to delivering existing vaccines. To address these challenges, the international community came together and formed the Global Alliance for Vaccines Initiative (GAVI. Sixteen years after the formation of GAVI, we see evidence of a healthier global vaccine landscape. We discuss how GAVI’s four guiding principles (product, health systems strengthening, financing and market shaping might apply to the advancement of medical diagnostics in LMICs. We present arguments for the international community and existing organizations to establish a Global Alliance for Medical Diagnostics Initiative (GAMDI.

A Case Study of How Organisational Members do Affect the Balancing of Exploitation and Exploration

DEFF Research Database (Denmark)

Andreassen, Mads R.

2008-01-01

study using semi-structured interviews and observation techniques this paper explores exploitation and exploration in a Danish industrial manufacture. Findings suggest that conditions affecting the balance between exploitation and exploration activities would depend on how an organisational member......Combing operations between the main parties in integration of new products, efficiently, are in practice for most organisations a challenging task demanding strong organisational capabilities, and in accordance to literature, achieving a successfully combination would be possible through...... an organisation's ability to establish dual capabilities in terms of exploitation and exploration (March, 1991). Few studies, however, suggest a classification of which organisational conditions would support a balance allowing exploitation and exploration operating side by side. Based on a single indept case...

Short-lived radionuclide production capability at the Brookhaven Linac Isotope Producer

International Nuclear Information System (INIS)

Mausner, L.F.; Richards, P.

1985-01-01

The Brookhaven National Linac Isotope Producer is the first facility to demonstrate the capability of a large linear accelerator for efficient and economical production of difficult-to-make, medically useful radionuclides. The linac provides a beam of 200-MeV protons at an integrated beam current of up to 60 μA. The 200-MeV proton energy is very suitable for isotope production because the spallation process can create radionuclides unavailable at lower energy accelerators or reactors. Several medically important short-lived radionuclides are presently being prepared for on-site and off-site collaborative research programs. These are iodine-123, iron-52, manganese-52m, ruthenium-97, and the rubidium-81-krypton-81m system. The production parameters for these are summarized

Co-Marketing Capability and its Impact on Marketing Allinace Performance

OpenAIRE

Schögel, Marcus; Herhausen, Dennis

2010-01-01

The aim of this paper is to conceptualize co-marketing capability (CMC) and to explore its relationship to marketing alliance performance. Drawing on a literature review, in-depth interviews with marketing alliance managers and consulting experience concerning co-marketing alliances, we established a multidimensional model of CMC. Using data from 287 chief marketing officers, we empirically show that the identified CMC is an important source of competitive advantage in terms of marketing alli...

Building Service Provider Capabilities

DEFF Research Database (Denmark)

Brandl, Kristin; Jaura, Manya; Ørberg Jensen, Peter D.

2015-01-01

In this paper we study whether and how the interaction between clients and the service providers contributes to the development of capabilities in service provider firms. In situations where such a contribution occurs, we analyze how different types of activities in the production process...... process. We find that clients influence the development of human capital capabilities and management capabilities in reciprocally produced services. While in sequential produced services clients influence the development of organizational capital capabilities and management capital capabilities....... of the services, such as sequential or reciprocal task activities, influence the development of different types of capabilities. We study five cases of offshore-outsourced knowledge-intensive business services that are distinguished according to their reciprocal or sequential task activities in their production...

An explorative study of school performance and antipsychotic medication

NARCIS (Netherlands)

van der Schans, J.; Vardar, S; Cicek, R.; Bos, H. J.; Hoekstra, P. J.; de Vries, T. W.; Hak, E.

2016-01-01

Background: Antipsychotic therapy can reduce severe symptoms of psychiatric disorders, however, data on school performance among children on such treatment are lacking. The objective was to explore school performance among children using antipsychotic drugs at the end of primary education. Methods:

The Space Launch System -The Biggest, Most Capable Rocket Ever Built, for Entirely New Human Exploration Missions Beyond Earth's Orbit

Science.gov (United States)

Shivers, C. Herb

2012-01-01

NASA is developing the Space Launch System -- an advanced heavy-lift launch vehicle that will provide an entirely new capability for human exploration beyond Earth's orbit. The Space Launch System will provide a safe, affordable and sustainable means of reaching beyond our current limits and opening up new discoveries from the unique vantage point of space. The first developmental flight, or mission, is targeted for the end of 2017. The Space Launch System, or SLS, will be designed to carry the Orion Multi-Purpose Crew Vehicle, as well as important cargo, equipment and science experiments to Earth's orbit and destinations beyond. Additionally, the SLS will serve as a backup for commercial and international partner transportation services to the International Space Station. The SLS rocket will incorporate technological investments from the Space Shuttle Program and the Constellation Program in order to take advantage of proven hardware and cutting-edge tooling and manufacturing technology that will significantly reduce development and operations costs. The rocket will use a liquid hydrogen and liquid oxygen propulsion system, which will include the RS-25D/E from the Space Shuttle Program for the core stage and the J-2X engine for the upper stage. SLS will also use solid rocket boosters for the initial development flights, while follow-on boosters will be competed based on performance requirements and affordability considerations.

Motivational Strategies in Medical English Classroom

Institute of Scientific and Technical Information of China (English)

TIAN Jun-ying

2014-01-01

Objective:To explore strategies to motivate students in the classroom of Medical English. Methods:The motivational strategies applied in medical English classroom including defining course goals early in the semester, appropriate teacher behavior, creating real context and giving helpful and frequent Feedback were recommended. Results & Conclusion: The motivational strategies make a positive impact on students’motivation in medical English classroom.

Risk-communication capability for public health emergencies varies by community diversity

Directory of Open Access Journals (Sweden)

Viswanath Kasisomayajula

2008-03-01

Full Text Available Abstract Background Public health emergencies heighten several challenges in risk-communication: providing trustworthy sources of information, reaching marginalized populations, and minimizing fear and public confusion. In emergencies, however, information may not diffuse equally among all social groups, and gaps in knowledge may increase. Such knowledge gaps vary by social structure and the size, socioeconomic status, and diversity of the population. This study explores the relationship between risk-communication capabilities, as perceived by public officials participating in emergency tabletop exercises, and community size and diversity. Findings For each of the three communication functions tested, risk-communication capabilities are perceived to be greater in communities with fewer then 10% of the population speaking a language other than English at home, decreasing as the percentage grows to 20% (ANOVA P ≤ 0.02. With respect to community size, however, we found an N-shaped relationship between perceived risk communication capabilities and population size. Capabilities are perceived highest in the largest communities and lowest in the smallest, but lower in communities with 20,000–49,999 inhabitants compared to those with 2,500–19,999. Conclusion The results of this study suggest the need to factor population diversity into risk communication plans and the need for improved state or regional risk-communication capabilities, especially for communities with limited local capacity.

Measuring hospital medical staff organizational structure.

Science.gov (United States)

Shortell, S M; Getzen, T E

1979-01-01

Based on organization theory and the work of Roemer and Friedman, seven dimensions of hospital medical staff organization structure are proposed and examined. The data are based on a 1973 nationwide survey of hospital medical staffs conducted by the American Hospital Association. Factor analysis yielded six relatively independent dimensions supporting a multidimensional view of medical staff organization structure. The six dimensions include 1) Resource Capability, 2) Generalist Physician Contractual Orientation, 3) Communication/Control, 4) Local Staff Orientation, 5) Participation in Decision Making, and 6) Hospital-Based Physician Contractual Orientation. It is suggested that these dimensions can be used to develop an empirical typology of hospital medical staff organization structure and to investigate the relationship between medical staff organization and public policy issues related to cost containment and quality assurance. PMID:511580

International exploration by independent

International Nuclear Information System (INIS)

Bertragne, R.G.

1992-01-01

Recent industry trends indicate that the smaller U.S. independents are looking at foreign exploration opportunities as one of the alternatives for growth in the new age of exploration. Foreign finding costs per barrel usually are accepted to be substantially lower than domestic costs because of the large reserve potential of international plays. To get involved in overseas exploration, however, requires the explorationist to adapt to different cultural, financial, legal, operational, and political conditions. Generally, foreign exploration proceeds at a slower pace than domestic exploration because concessions are granted by a country's government, or are explored in partnership with a national oil company. First, the explorationist must prepare a mid- to long-term strategy, tailored to the goals and the financial capabilities of the company; next, is an ongoing evaluation of quality prospects in various sedimentary basins, and careful planning and conduct of the operations. To successfully explore overseas also requires the presence of a minimum number of explorationists and engineers thoroughly familiar with the various exploratory and operational aspects of foreign work. Ideally, these team members will have had a considerable amount of on-site experience in various countries and climates. Independents best suited for foreign expansion are those who have been financially successful in domestic exploration. When properly approached, foreign exploration is well within the reach of smaller U.S. independents, and presents essentially no greater risk than domestic exploration; however, the reward can be much larger and can catapult the company into the 'big leagues.'

Qualitative descriptive study exploring schizophrenia and the everyday effect of medication-induced weight gain.

Science.gov (United States)

Vandyk, Amanda Digel; Baker, Cynthia

2012-08-01

Weight gain and obesity are serious side effects of the medications used to manage psychotic disorders and successful, long-term weight loss interventions are not yet available. One reason for this may be that current interventions are designed without consideration of the patient's perspective. The purpose of this study was to explore the subjective experience of weight and lifestyle from the perspective of people with schizophrenia. A qualitative, constructivist research design was used and conversational interviews were conducted with 18 purposefully recruited participants from an outpatient clinic at a psychiatric hospital in Eastern Ontario. Data were analysed according to the method of constant comparison and three central themes emerged: a life altering diagnosis, weight management as complex, and today's experiences shape tomorrow's outcomes. Weight management was seen as difficult yet important to the participants. The findings of this study provide insight into the views and opinions of the participants regarding weight and lifestyle and may be used to support the design of tailored heath initiatives for persons with mental illness. © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Exploring multiple sources of climatic information within personal and medical diaries, Bombay 1799-1828

Science.gov (United States)

Adamson, George

2016-04-01

Private diaries are being recognised as an important source of information on past climatic conditions, providing place-specific, often daily records of meteorological information. As many were not intended for publication, or indeed to be read by anyone other than the author, issues of observer bias are lower than some other types of documentary sources. This paper comprises an exploration of the variety of types of climatic information can be mined from a single document or set of documents. The focus of the analysis is three private and one medical diary kept by British colonists in Bombay, western India, during the first decades of the nineteenth century. The paper discusses the potential of the diaries for reconstruction of precipitation, temperature and extreme events. Ad-hoc temperature observations collected by the four observers prove to be particularly fruitful for reconstructing monthly extreme temperatures, with values comparable to more systematic observations collected during the period. This leads to a tentative conclusion that extreme temperatures in Bombay were around 5°C lower during the period than today, a difference likely predominantly attributable to the urban heat island effect.

Content and discontent: a qualitative exploration of obstacles to elearning engagement in medical students.

Science.gov (United States)

Reid, Helen J; Thomson, Clare; McGlade, Kieran J

2016-07-22

Elearning is ubiquitous in healthcare professions education. Its equivalence to 'traditional' educational delivery methods is well established. There is a research imperative to clarify when and how to use elearning most effectively to mitigate the potential of it becoming merely a 'disruptive technology.' Research has begun to broadly identify challenges encountered by elearning users. In this study, we explore in depth the perceived obstacles to elearning engagement amongst medical students. Sensitising concepts of achievement emotions and the cognitive demands of multi-tasking highlight why students' deeply emotional responses to elearning may be so important in their learning. This study used focus groups as a data collection tool. A purposeful sample of 31 participated. Iterative data gathering and analysis phases employed a constant comparative approach to generate themes firmly grounded in participant experience. Key themes that emerged from the data included a sense of injustice, passivity and a feeling of being 'lost at sea'. The actual content of the elearning resource provided important context. The identified themes have strong emotional foundations. These responses, interpreted through the lens of achievement emotions, have not previously been described. Appreciation of their importance is of benefit to educators involved in curriculum development or delivery.

Grid-supported Medical Digital Library.

Science.gov (United States)

Kosiedowski, Michal; Mazurek, Cezary; Stroinski, Maciej; Weglarz, Jan

2007-01-01

Secure, flexible and efficient storing and accessing digital medical data is one of the key elements for delivering successful telemedical systems. To this end grid technologies designed and developed over the recent years and grid infrastructures deployed with their use seem to provide an excellent opportunity for the creation of a powerful environment capable of delivering tools and services for medical data storage, access and processing. In this paper we present the early results of our work towards establishing a Medical Digital Library supported by grid technologies and discuss future directions of its development. These works are part of the "Telemedycyna Wielkopolska" project aiming to develop a telemedical system for the support of the regional healthcare.

Hedging Capabilities of Bitcoin. Is it the virtual gold?

OpenAIRE

Dyhrberg, Anne Haubo

2015-01-01

This paper sets out to explore the hedging capabilities of bitcoin by applying the asymmetric GARCH methodology used in investigation of gold. The results show that bitcoin can clearly be used as a hedge against stocks in the Financial Times Stock Exchange Index. Additionally bitcoin can be used as a hedge against the American dollar in the short-term. Bitcoin thereby possess some of the same hedging abilities as gold and can be included in the variety of tools available to market analysts to...

3D Printing: Exploring Capabilities

Science.gov (United States)

Samuels, Kyle; Flowers, Jim

2015-01-01

As 3D printers become more affordable, schools are using them in increasing numbers. They fit well with the emphasis on product design in technology and engineering education, allowing students to create high-fidelity physical models to see and test different iterations in their product designs. They may also help students to "think in three…

Crew Exploration Vehicle Service Module Ascent Abort Coverage

Science.gov (United States)

Tedesco, Mark B.; Evans, Bryan M.; Merritt, Deborah S.; Falck, Robert D.

2007-01-01

The Crew Exploration Vehicle (CEV) is required to maintain continuous abort capability from lift off through destination arrival. This requirement is driven by the desire to provide the capability to safely return the crew to Earth after failure scenarios during the various phases of the mission. This paper addresses abort trajectory design considerations, concept of operations and guidance algorithm prototypes for the portion of the ascent trajectory following nominal jettison of the Launch Abort System (LAS) until safe orbit insertion. Factors such as abort system performance, crew load limits, natural environments, crew recovery, and vehicle element disposal were investigated to determine how to achieve continuous vehicle abort capability.

FMEF/experimental capabilities

International Nuclear Information System (INIS)

Burgess, C.A.; Dronen, V.R.

1981-01-01

The Fuels and Materials Examination Facility (FMEF), under construction at the Hanford site north of Richland, Washington, will be one of the most modern facilities offering irradiated fuels and materials examination capabilities and fuel fabrication development technologies. Scheduled for completion in 1984, the FMEF will provide examination capability for fuel assemblies, fuel pins and test pins irradiated in the FFTF. Various functions of the FMEF are described, with emphasis on experimental data-gathering capabilities in the facility's Nondestructive and Destructive examination cell complex

Medication communication through documentation in medical wards: knowledge and power relations.

Science.gov (United States)

Liu, Wei; Manias, Elizabeth; Gerdtz, Marie

2014-09-01

Health professionals communicate with each other about medication information using different forms of documentation. This article explores knowledge and power relations surrounding medication information exchanged through documentation among nurses, doctors and pharmacists. Ethnographic fieldwork was conducted in 2010 in two medical wards of a metropolitan hospital in Australia. Data collection methods included participant observations, field interviews, video-recordings, document retrieval and video reflexive focus groups. A critical discourse analytic framework was used to guide data analysis. The written medication chart was the main means of communicating medication decisions from doctors to nurses as compared to verbal communication. Nurses positioned themselves as auditors of the medication chart and scrutinised medical prescribing to maintain the discourse of patient safety. Pharmacists utilised the discourse of scientific judgement to guide their decision-making on the necessity of verbal communication with nurses and doctors. Targeted interdisciplinary meetings involving nurses, doctors and pharmacists should be organised in ward settings to discuss the importance of having documented medication information conveyed verbally across different disciplines. Health professionals should be encouraged to proactively seek out each other to relay changes in medication regimens and treatment goals. © 2013 John Wiley & Sons Ltd.

Leadership capabilities of physiotherapy leaders in Ireland: Part 2. Clinical specialists and advanced physiotherapy practitioners.

Science.gov (United States)

McGowan, E; Elliott, N; Stokes, E

2018-05-07

Investigation of the leadership capabilities of physiotherapy managers found that they report predominantly demonstrating capabilities associated with the human resource and structural frames. However, little is known about the leadership capabilities of clinical specialists and advanced physiotherapy practitioners (APPs) who also are identified as having responsibility for leadership. To explore clinical specialists´ and APPs' perceptions of their leadership capabilities and compare them with the reported leadership capabilities of physiotherapy managers. Semi-structured interviews were conducted with a purposive sample of 17 physiotherapy clinical specialists and APPs from a range of practice settings across Ireland. The interviews were analyzed using template analysis and the coding template was based on the Bolman and Deal Leadership framework. The participants described demonstrating leadership capabilities associated with each of the four leadership frames. However, the language used by the clinical specialists/APPs suggested that they work predominantly through the human resource frame. Structural frame capabilities were reported by the clinical specialists/APPs and there were some differences to those reported by the managers. In keeping with the reported leadership capabilities of the physiotherapy managers, the employment of capabilities associated with the political frame varied between participants and symbolic frame capabilities were underused. There are many similarities in the self-reported leadership capabilities of managers and clinical specialists/APPs. However, differences were also noted. Both cohorts of physiotherapy leaders may benefit from specific development programs to develop leadership capabilities associated with the political and symbolic frames.

Identifying deficiencies in national and foreign medical team responses through expert opinion surveys: implications for education and training.

Science.gov (United States)

Djalali, Ahmadreza; Ingrassia, Pier Luigi; Corte, Francesco Della; Foletti, Marco; Gallardo, Alba Ripoll; Ragazzoni, Luca; Kaptan, Kubilay; Lupescu, Olivera; Arculeo, Chris; von Arnim, Gotz; Friedl, Tom; Ashkenazi, Michael; Heselmann, Deike; Hreckovski, Boris; Khorram-Manesh, Amir; Khorrram-Manesh, Amir; Komadina, Radko; Lechner, Kostanze; Patru, Cristina; Burkle, Frederick M; Fisher, Philipp

2014-08-01

Unacceptable practices in the delivery of international medical assistance are reported after every major international disaster; this raises concerns about the clinical competence and practice of some foreign medical teams (FMTs). The aim of this study is to explore and analyze the opinions of disaster management experts about potential deficiencies in the art and science of national and FMTs during disasters and the impact these opinions might have on competency-based education and training. This qualitative study was performed in 2013. A questionnaire-based evaluation of experts' opinions and experiences in responding to disasters was conducted. The selection of the experts was done using the purposeful sampling method, and the sample size was considered by data saturation. Content analysis was used to explore the implications of the data. This study shows that there is a lack of competency-based training for disaster responders. Developing and performing standardized training courses is influenced by shortcomings in budget, expertise, and standards. There is a lack of both coordination and integration among teams and their activities during disasters. The participants of this study emphasized problems concerning access to relevant resources during disasters. The major findings of this study suggest that teams often are not competent during the response phase because of education and training deficiencies. Foreign medical teams and medically related nongovernmental organizations (NGOs) do not always provide expected capabilities and services. Failures in leadership and in coordination among teams are also a problem. All deficiencies need to be applied to competency-based curricula.

Self-Assessment of Problem Solving Disposition in Medical Students

OpenAIRE

Olivares-Olivares, Silvia Lizett; López-Cabrera, Mildred Vanessa

2014-01-01

Medical schools are committed to both students and society to develop capabilities required to succeed in health care environments. Present diagnosis and treatment methods become obsolete faster, demanding that medical schools incorporate competency-based education to keep pace with future demands. This study was conducted to assess the problem solving disposition of medical students. A three-subcategory model of the skill is proposed. The instrument was validated on content by a group of 17 ...

Patient safety and technology-driven medication

DEFF Research Database (Denmark)

Orbæk, Janne; Gaard, Mette; Keinicke Fabricius, Pia

2015-01-01

ways of educating nursing students in today's medication administration. AIM: To explore nursing students' experiences and competences with the technology-driven medication administration process. METHODS: 16 pre-graduate nursing students were included in two focus group interviews which were recorded...... for the technology-driven medication process, nursing students face difficulties in identifying and adopting best practices. The impact of using technology on the frequency, type and severity of medication errors; the technologies implications on nursing professionalism and the nurses ability to secure patient...

Business continuity after catastrophic medical events: the Joplin medical business continuity report.

Science.gov (United States)

Carlton, Paul K; Bringle, Dottie

2012-01-01

On May 22, 2011, The St Johns Mercy Medical Center in Joplin, MO, was destroyed by an F-5 tornado. There were 183 patients in the building at that time in this 367-bed Medical Center. The preparation and response were superbly done and resulted in many lives saved. This report is focused on the reconstitution phase of this disaster response, which includes how to restore business continuity. As 95 percent of our medical capacity resides in the private sector in the United States, we must have a proper plan for how to restore business continuity or face the reality of the medical business failing and not providing critical medical services to the community. A tornado in 2007 destroyed a medical center in Sumter County, GA, and it took more than 365 days to restore business continuity at a cost of $18M. The plan executed by the Mercy Medical System after the disaster in Joplin restored business continuity in 88 days and cost a total of $6.6M, with all assets being reusable. The recommendation from these lessons learned is that every county, state, and Federal Emergency Management Agency region has a plan on the shelf to restore business continuity and the means to be able to do so. The hard work that the State of Missouri and the Mercy Medical System did after this disaster can serve as a model for the nation in how to quickly recover from any loss of medical capability.

Knowledge and Practice of Self-medication among Undergraduate Medical Students

Directory of Open Access Journals (Sweden)

Anishma Karmacharya

2018-05-01

Full Text Available Introduction: Self-medication is an important aspect of self-care. It is a common practice in society and medical students are no exception. The aim of this study was to explore the knowledge and practice of self-medication among students of a medical school in Western Nepal. Methods: A cross sectional study was conducted among basic science and clinical students after obtaining prior consent from those willing to participate. Respondents’ degree of agreement with a set of 25 statements was noted using Likert scale to assess their knowledge. The practice of self-medication was studied by asking about the use of selected groups of medicines during the past one-year period and noting the pattern of use. Results: Three hundred and thirty of the 356 students (92.6% participated in the study. Mean knowledge score was 93.2 (SD = 8.1. Self-medication was practiced by 83.3% (n = 275 of respondents. Knowledge about self-medication differed among respondents according to gender (p = 0.03 and nationality (p = 0.04 but not other variables. Practice of self-medication was associated with father’s profession (p = 0.03 and nationality of the respondents (p = 0.04. Conclusions: Students’ knowledge about self-medication was good and they commonly practiced self-medication. Pain-killers were the most commonly used drug.

Human Exploration of the Solar System by 2100

Science.gov (United States)

Litchford, Ronald J.

2017-01-01

It has been suggested that the U.S., in concert with private entities and international partners, set itself on a course to accomplish human exploration of the solar system by the end of this century. This is a strikingly bold vision intended to revitalize the aspirations of HSF in service to the security, economic, and scientific interests of the nation. Solar system distance and time scales impose severe requirements on crewed space transportation systems, however, and fully realizing all objectives in support of this goal will require a multi-decade commitment employing radically advanced technologies - most prominently, space habitats capable of sustaining and protecting life in harsh radiation environments under zero gravity conditions and in-space propulsion technologies capable of rapid deep space transits with earth return, the subject of this paper. While near term mission destinations such as the moon and Mars can be accomplished with chemical propulsion and/or high power SEP, fundamental capability constraints render these traditional systems ineffective for solar system wide exploration. Nuclear based propulsion and alternative energetic methods, on the other hand, represent potential avenues, perhaps the only viable avenues, to high specific power space transport evincing reduced trip time, reduced IMLEO, and expanded deep space reach. Here, very long term HSF objectives for solar system wide exploration are examined in relation to the advanced propulsion technology solution landscape including foundational science, technical/engineering challenges, and developmental prospects.

Developing Alliance Capabilities

DEFF Research Database (Denmark)

Heimeriks, Koen H.; Duysters, Geert; Vanhaverbeke, Wim

This paper assesses the differential performance effects of learning mechanisms on the development of alliance capabilities. Prior research has suggested that different capability levels could be identified in which specific intra-firm learning mechanisms are used to enhance a firm's alliance...

Eco-medical tourism: can it be sustainable?

Science.gov (United States)

Robert S. Bristow

2009-01-01

Medical tourism has gained popularity over the past few years. While its roots may be found in the Neolithic and Bronze Ages with visits to mineral springs around the Mediterranean, current medical tourism is more likely to be driven by patients seeking less expensive medical procedures in eastern Europe, southeast Asia, and Latin America. This paper explores the role...

Role of illness perceptions and medication beliefs on medication compliance of elderly hypertensive cohorts.

Science.gov (United States)

Rajpura, Jigar R; Nayak, Rajesh

2014-02-01

Poor compliance with antihypertensive medications is one possible reason why its success in clinical trials has not been translated into everyday practice. In addition, medication noncompliance in elderly leads to increased hospitalizations, physician visits, and higher health care costs. The study assessed influence of illness perceptions and medications beliefs on medication compliance of elderly hypertensive cohorts. A cross-sectional survey research design, utilizing self-administered health surveys, was adapted to address key study objectives. Conceptualized associations among the study variables were explored to assess their individual as well as their collective impact on the medication compliance. A total of 78 (66%) study samples were found to be noncompliant with their medications. Analysis revealed that perceptions about illness and beliefs about medication jointly played a significant role in the prediction of medication compliance (F = 5.966, P compliance building in elderly populations having hypertension by incorporating the value and importance of patient perceptions of illness and medications in order to achieve desired patient outcomes.

Medical implication in the Bible and its relevance to modern medicine.

Science.gov (United States)

Sun, Jun-Fang

2013-11-01

The Holy Bible, as the root of Western civilization, has imposed great influence in the fields far beyond religion. In this thesis, the author intended to reveal the medical implication in the Holy Bible and its relevance to the modern medical science by exploring the biblical medical information and comparing it with the current medical theory and practice. The conclusion of the exploration is surprising yet inspiring: the Holy Bible, as an ancient religious book, contains rich medical information around themes such as sexual relations, dietary guidelines, hygiene, etc., which is not at odds, but in harmony with the modern medicine.

Computers, the Internet and medical education in Africa.

Science.gov (United States)

Williams, Christopher D; Pitchforth, Emma L; O'Callaghan, Christopher

2010-05-01

OBJECTIVES This study aimed to explore the use of information and communications technology (ICT) in undergraduate medical education in developing countries. METHODS Educators (deans and heads of medical education) in English-speaking countries across Africa were sent a questionnaire to establish the current state of ICT at medical schools. Non-respondents were contacted firstly by e-mail, subsequently by two postal mailings at 3-month intervals, and finally by telephone. Main outcome measures included cross-sectional data about the availability of computers, specifications, Internet connection speeds, use of ICT by students, and teaching of ICT and computerised research skills, presented by country or region. RESULTS The mean computer : student ratio was 0.123. Internet speeds were rated as 'slow' or 'very slow' on a 5-point Likert scale by 25.0% of respondents overall, but by 58.3% in East Africa and 33.3% in West Africa (including Cameroon). Mean estimates showed that campus computers more commonly supported CD-ROM (91.4%) and sound (87.3%) than DVD-ROM (48.1%) and Internet (72.5%). The teaching of ICT and computerised research skills, and the use of computers by medical students for research, assignments and personal projects were common. CONCLUSIONS It is clear that ICT infrastructure in Africa lags behind that in other regions. Poor download speeds limit the potential of Internet resources (especially videos, sound and other large downloads) to benefit students, particularly in East and West (including Cameroon) Africa. CD-ROM capability is more widely available, but has not yet gained momentum as a means of distributing materials. Despite infrastructure limitations, ICT is already being used and there is enthusiasm for developing this further. Priority should be given to developing partnerships to improve ICT infrastructure and maximise the potential of existing technology.

Virtue in Medical Practice: An Exploratory Study.

Science.gov (United States)

Kotzee, Ben; Ignatowicz, Agnieszka; Thomas, Hywel

2017-03-01

Virtue ethics has long provided fruitful resources for the study of issues in medical ethics. In particular, study of the moral virtues of the good doctor-like kindness, fairness and good judgement-have provided insights into the nature of medical professionalism and the ethical demands on the medical practitioner as a moral person. Today, a substantial literature exists exploring the virtues in medical practice and many commentators advocate an emphasis on the inculcation of the virtues of good medical practice in medical education and throughout the medical career. However, until very recently, no empirical studies have attempted to investigate which virtues, in particular, medical doctors and medical students tend to have or not to have, nor how these virtues influence how they think about or practise medicine. The question of what virtuous medical practice is, is vast and, as we have written elsewhere, the question of how to study doctors' moral character is fraught with difficulty. In this paper, we report the results of a first-of-a-kind study that attempted to explore these issues at three medical schools (and associated practice regions) in the United Kingdom. We identify which character traits are important in the good doctor in the opinion of medical students and doctors and identify which virtues they say of themselves they possess and do not possess. Moreover, we identify how thinking about the virtues contributes to doctors' and medical students' thinking about common moral dilemmas in medicine. In ending, we remark on the implications for medical education.

Medical Rituals and Media Rituals

Directory of Open Access Journals (Sweden)

Zoltán Zsinkó-Szabó

2013-01-01

Full Text Available In the present article the author examines the ritual elements of theprofessionalization during medical studies, and its interference with media content of medical significance, comparing the role of medical and media rituals on the way of becoming a doctor. It is to be explored how these medical soap operas, medical dramas, medical thrillers or crime stories do exert influence on medical identity and role expectations. Do medical students and their relatives (withmedical expertise frequently identify themselves with these roles? Is their way of reception critical or naïve? How media rituals are organizing, modulating the students’ medical perception and expectations. Is there a mediated “shadow initiation” via media or it is excluded and denied? Does it perfuse the common social experience of becoming a doctor via peer communication and peer shapingof model behavior? We search the answers in the context of a theory of media rituals.

Antarctic Exploration Parallels for Future Human Planetary Exploration: Science Operations Lessons Learned, Planning, and Equipment Capabilities for Long Range, Long Duration Traverses

Science.gov (United States)

Hoffman, Stephen J.

2012-01-01

The purpose for this workshop can be summed up by the question: Are there relevant analogs to planetary (meaning the Moon and Mars) to be found in polar exploration on Earth? The answer in my opinion is yes or else there would be no reason for this workshop. However, I think some background information would be useful to provide a context for my opinion on this matter. As all of you are probably aware, NASA has been set on a path that, in its current form, will eventually lead to putting human crews on the surface of the Moon and Mars for extended (months to years) in duration. For the past 50 V 60 years, starting not long after the end of World War II, exploration of the Antarctic has accumulated a significant body of experience that is highly analogous to our anticipated activities on the Moon and Mars. This relevant experience base includes: h Long duration (1 year and 2 year) continuous deployments by single crews, h Established a substantial outpost with a single deployment event to support these crews, h Carried out long distance (100 to 1000 kilometer) traverses, with and without intermediate support h Equipment and processes evolved based on lessons learned h International cooperative missions This is not a new or original thought; many people within NASA, including the most recent two NASA Administrators, have commented on the recognizable parallels between exploration in the Antarctic and on the Moon or Mars. But given that level of recognition, relatively little has been done, that I am aware of, to encourage these two exploration communities to collaborate in a significant way. [Slide 4] I will return to NASA s plans and the parallels with Antarctic traverses in a moment, but I want to spend a moment to explain the objective of this workshop and the anticipated products. We have two full days set aside for this workshop. This first day will be taken up with a series of presentations prepared by individuals with experience that extends back as far as the

Patient Workload Profile: National Naval Medical Center (NNMC), Bethesda, MD.

Science.gov (United States)

1980-06-01

AD-A09a 729 WESTEC SERVICES NC SAN DIEGOCA0S / PATIENT WORKLOAD PROFILE: NATIONAL NAVAL MEDICAL CENTER NNMC),- ETC(U) JUN 80 W T RASMUSSEN, H W...provides site workload data for the National Naval Medical Center (NNMC) within the following functional support areas: Patient Appointment...on managing medical and patient data, thereby offering the health care provider and administrator more powerful capabilities in dealing with and

Building technological capability within satellite programs in developing countries

Science.gov (United States)

Wood, Danielle; Weigel, Annalisa

2011-12-01

This paper explores the process of building technological capability in government-led satellite programs within developing countries. The key message is that these satellite programs can learn useful lessons from literature in the international development community. These lessons are relevant to emerging satellite programs that leverage international partnerships in order to establish local capability to design, build and operate satellites. Countries with such programs include Algeria, Nigeria, Turkey, Malaysia and the United Arab Emirates. The paper first provides background knowledge about space activity in developing countries, and then explores the nuances of the lessons coming from the international development literature. Developing countries are concerned with satellite technology because satellites provide useful services in the areas of earth observation, communication, navigation and science. Most developing countries access satellite services through indirect means such as sharing data with foreign organizations. More countries, however, are seeking opportunities to develop satellite technology locally. There are objective, technically driven motivations for developing countries to invest in satellite technology, despite rich debate on this topic. The paper provides a framework to understand technical motivations for investment in satellite services, hardware, expertise and infrastructure in both short and long term. If a country decides to pursue such investments they face a common set of strategic decisions at the levels of their satellite program, their national context and their international relationships. Analysis of past projects shows that countries have chosen diverse strategies to address these strategic decisions and grow in technological capability. What is similar about the historical examples is that many countries choose to leverage international partnerships as part of their growth process. There are also historical examples from

Behavioral Exploration of Career and Specialty Choice in Medical Students

Science.gov (United States)

Borges, Nicole J.

2007-01-01

Understanding the process by which students naturally construct and internalize their educational experiences relating to career development is important to career counseling. The author investigated how exploratory behaviors during a community-based field experience course contributed to the vocational development of 1st-year medical students.…

Dental optical coherence domain reflectometry explorer

Energy Technology Data Exchange (ETDEWEB)

Everett, Matthew J. (Livermore, CA); Colston, Jr., Billy W. (Livermore, CA); Sathyam, Ujwal S. (Livermore, CA); Da Silva, Luiz B. (Pleasanton, CA)

2001-01-01

A hand-held, fiber optic based dental device with optical coherence domain reflectometry (OCDR) sensing capabilities provides a profile of optical scattering as a function of depth in the tissue at the point where the tip of the dental explorer touches the tissue. This system provides information on the internal structure of the dental tissue, which is then used to detect caries and periodontal disease. A series of profiles of optical scattering or tissue microstructure are generated by moving the explorer across the tooth or other tissue. The profiles are combined to form a cross-sectional, or optical coherence tomography (OCT), image.

HR Explorer

CERN Document Server

Möller, M

1997-01-01

At the European Laboratory for Particle Physics Research (CERN), Geneva Switzerland we are using OracleHR for managing our human resources since 1995. After the first year of production it became clear that there was a strong need for an easy-to-use Decision Support Tool exploring the data in OracleHR. This paper illustrates an approach which we have adopted to provide on-line management reporting, multi-dimensional analysis, drill-down and slicing & dicing of data, warehoused from OracleHR. The tool offers strong resource management and planning capabilities including career follow-up. The user management and security monitoring are implemented using the Oracle WebServer.

Exploring the Value of the Capability Approach for Vocational Education and Training Evaluation: Reflections from South Africa

Directory of Open Access Journals (Sweden)

Lesley Powell

2014-11-01

Full Text Available In the late 1990s, South Africa faced the three-fold challenge of reforming the apartheid-divided institutional landscape of vocational education and training (VET institutions; ensuring equitable access to skills; and reorienting its skills development system in line with the nation’s reinsertion into the global economy. A wave of institutional reforms was enacted which was followed by a large programme of evaluative research. While this body of work was both valuable and necessary, it nonetheless had several limitations. As part of efforts to overcome these, the authors suggest an alternative evaluation method that draws on insights from the ‘capability approach’. By putting the needs of people first – rather than the needs of the economy – the capability approach emphasises social justice, human rights and poverty alleviation in VET evaluation. This approach is more focused on the values and goals of individuals and institutions, while retaining the economic rationale as a key analytical tool and emphasising the continued importance of evaluation for the improvement of delivery and outcomes.

A web-based knowledge management system integrating Western and Traditional Chinese Medicine for relational medical diagnosis.

Science.gov (United States)

Herrera-Hernandez, Maria C; Lai-Yuen, Susana K; Piegl, Les A; Zhang, Xiao

2016-10-26

This article presents the design of a web-based knowledge management system as a training and research tool for the exploration of key relationships between Western and Traditional Chinese Medicine, in order to facilitate relational medical diagnosis integrating these mainstream healing modalities. The main goal of this system is to facilitate decision-making processes, while developing skills and creating new medical knowledge. Traditional Chinese Medicine can be considered as an ancient relational knowledge-based approach, focusing on balancing interrelated human functions to reach a healthy state. Western Medicine focuses on specialties and body systems and has achieved advanced methods to evaluate the impact of a health disorder on the body functions. Identifying key relationships between Traditional Chinese and Western Medicine opens new approaches for health care practices and can increase the understanding of human medical conditions. Our knowledge management system was designed from initial datasets of symptoms, known diagnosis and treatments, collected from both medicines. The datasets were subjected to process-oriented analysis, hierarchical knowledge representation and relational database interconnection. Web technology was implemented to develop a user-friendly interface, for easy navigation, training and research. Our system was prototyped with a case study on chronic prostatitis. This trial presented the system's capability for users to learn the correlation approach, connecting knowledge in Western and Traditional Chinese Medicine by querying the database, mapping validated medical information, accessing complementary information from official sites, and creating new knowledge as part of the learning process. By addressing the challenging tasks of data acquisition and modeling, organization, storage and transfer, the proposed web-based knowledge management system is presented as a tool for users in medical training and research to explore, learn and

Crew systems: integrating human and technical subsystems for the exploration of space

Science.gov (United States)

Connors, M. M.; Harrison, A. A.; Summit, J.

1994-01-01

Space exploration missions will require combining human and technical subsystems into overall "crew systems" capable of performing under the rigorous conditions of outer space. This report describes substantive and conceptual relationships among humans, intelligent machines, and communication systems, and explores how these components may be combined to complement and strengthen one another. We identify key research issues in the combination of humans and technology and examine the role of individual differences, group processes, and environmental conditions. We conclude that a crew system is, in effect, a social cyborg, a living system consisting of multiple individuals whose capabilities are extended by advanced technology.

Medication adherence among transgender women living with HIV

OpenAIRE

Baguso, Glenda N.; Gay, Caryl L.; Lee, Kathryn A.

2016-01-01

Medication adherence is linked to health outcomes among adults with HIV infection. Transgender women living with HIV (TWLWH) in the U.S. report suboptimal adherence to medications and are found to have difficulty integrating HIV medication into their daily routine, but few studies explore factors associated with medication adherence among transgender women. Thus, the purpose of this paper is to examine demographic and clinical factors related to self-reported medication adherence among transg...

Physical and cognitive capability in mid-adulthood as determinants of retirement and extended working life in a British cohort study

OpenAIRE

Stafford, M.; Cooper, R.; Cadar, D.; Carr, E.; Murray, E.; Richards, M.; Stansfeld, S.; Zaninotto, P.; Head, J.; Kuh, D.

2017-01-01

Objective Policy in many industrialized countries increasingly emphasizes extended working life. We examined associations between physical and cognitive capability in mid-adulthood and work in late adulthood. Methods Using self-reported physical limitations and performance-based physical and cognitive capability at age 53, assessed by trained nurses from the Medical Research Council (MRC) National Survey of Health and Development, we examined prospective associations with extended working (ca...

Physical and cognitive capability in mid-adulthood as determinants of retirement and extended working life in a British cohort study

OpenAIRE

Stafford, M.; Cooper, R.; Cadar, D.; Carr, E.; Murray, E.; Richards, M.; Stansfeld, S.; Zaninotto, P.; Head, J.; Kuh, D.

2017-01-01

OBJECTIVE: Policy in many industrialized countries increasingly emphasizes extended working life. We examined associations between physical and cognitive capability in mid-adulthood and work in late adulthood. METHODS: Using self-reported physical limitations and performance-based physical and cognitive capability at age 53, assessed by trained nurses from the Medical Research Council (MRC) National Survey of Health and Development, we examined prospective associations with extended working (...

Transforming organizational capabilities in strategizing

DEFF Research Database (Denmark)

Jørgensen, Claus; Friis, Ole Uhrskov; Koch, Christian

2014-01-01

Offshored and networked enterprises are becoming an important if not leading organizational form and this development seriously challenges their organizational capabilities. More specifically, over the last years, SMEs have commenced entering these kinds of arrangements. As the organizational...... capabilities of SMEs are limited at the outset, even more emphasis is needed regarding the issues of developing relevant organizational capabilities. This paper aims at investigating how capabilities evolve during an offshoring process of more than 5 years in two Danish SMEs, i.e. not only short- but long......-term evolvements within the companies. We develop our framework of understanding organizational capabilities drawing on dynamic capability, relational capability and strategy as practice concepts, appreciating the performative aspects of developing new routines. Our two cases are taken from one author’s Ph...

"Yes, and …" Exploring the Future of Learning Analytics in Medical Education.

Science.gov (United States)

Cirigliano, Matt M; Guthrie, Charlie; Pusic, Martin V; Cianciolo, Anna T; Lim-Dunham, Jennifer E; Spickard, Anderson; Terry, Valerie

2017-01-01

This Conversations Starter article presents a selected research abstract from the 2017 Association of American Medical Colleges Northeastern Region Group on Educational Affairs annual spring meeting. The abstract is paired with the integrative commentary of three experts who shared their thoughts stimulated by the study. Commentators brainstormed "what's next" with learning analytics in medical education, including advancements in interaction metrics and the use of interactivity analysis to deepen understanding of perceptual, cognitive, and social learning and transfer processes.

Polymeric Medical Sutures: An Exploration of Polymers and Green Chemistry

Science.gov (United States)

Knutson, Cassandra M.; Schneiderman, Deborah K.; Yu, Ming; Javner, Cassidy H.; Distefano, Mark D.; Wissinger, Jane E.

2017-01-01

With new K-12 national science standards emerging, there is an increased need for experiments that integrate engineering into the context of society. Here we describe a chemistry experiment that combines science and engineering principles while introducing basic polymer and green chemistry concepts. Using medical sutures as a platform for…

NASA Advanced Exploration Systems: Advancements in Life Support Systems

Science.gov (United States)

Shull, Sarah A.; Schneider, Walter F.

2016-01-01

The NASA Advanced Exploration Systems (AES) Life Support Systems (LSS) project strives to develop reliable, energy-efficient, and low-mass spacecraft systems to provide environmental control and life support systems (ECLSS) critical to enabling long duration human missions beyond low Earth orbit (LEO). Highly reliable, closed-loop life support systems are among the capabilities required for the longer duration human space exploration missions assessed by NASA’s Habitability Architecture Team.

How do dynamic capabilities transform external technologies into firms’ renewed technological resources? – A mediation model

DEFF Research Database (Denmark)

Li-Ying, Jason; Wang, Yuandi; Ning, Lutao

2016-01-01

microfoundations of dynamic technological capabilities, mediate the relationship between external technology breadth and firms’ technological innovation performance, based on the resource-based view and dynamic capability view. Using a sample of listed Chinese licensee firms, we find that firms must broadly......How externally acquired resources may become valuable, rare, hard-to-imitate, and non-substitute resource bundles through the development of dynamic capabilities? This study proposes and tests a mediation model of how firms’ internal technological diversification and R&D, as two distinctive...... explore external technologies to ignite the dynamism in internal technological diversity and in-house R&D, which play their crucial roles differently to transform and reconfigure firms’ technological resources....

[Nursing workplace bullying and turnover intention: an exploration of associated factors at a medical center in Southern Taiwan].

Science.gov (United States)

Tsai, Shiau-Ting; Han, Chin-Hua; Chen, Li-Fang; Chou, Fan-Hao

2014-06-01

The chronic shortage of nursing staffs in hospitals continues to increasingly and negatively impact the ability of medical care systems to deliver effective care and ensure the safety of patients. Bullying is one factor known to exacerbate turnover in the nursing workplace. This study explores workplace bullying and turnover intention among nurses working at a medical center in Southern Taiwan. A cross-sectional and correlation research design was conducted using the Negative Acts Questionnaire-Revised (NAQ-R) and the Turnover Intention Questionnaire. A convenience, purposive sample of 708 nurses was recruited. Inclusion criteria included: holding an RN license, able to communicate in both Mandarin and Hokkienese, >6 months of clinical experience, and an NAQ-R score higher than 23. Data were analyzed using SPSS19.0 software. Approximately 85% of participants had experienced some degree of workplace bullying during the previous 6-month period. The trend of the turnover intention tended to the right at a high degree. A moderate, positive, and significant correlation was found between turnover intention and bullying total scores (r=.39, pturnover intention (15.10%). Based on our findings, we suggest that nurses should enhance their awareness of the negative consequences of workplace bullying. Furthermore, hospitals should implement appropriate mechanisms to decrease the phenomenon of inter-staff bullying, improve the nursing workplace environment, and reduce the rate of turnover intention.

Associations between medical school and career preferences in Year 1 medical students in Scotland.

Science.gov (United States)

Cleland, Jennifer; Johnston, Peter W; French, Fiona H; Needham, Gillian

2012-05-01

Little is known about the relationship between the career preferences of medical students and the medical schools at which they are enrolled. Our aim was to explore this relationship early in students' medical training. Year 1 (2009-2010) medical students at the five Scottish medical schools were invited to take part in a career preference questionnaire survey. Questions were asked about demographic factors, career preferences and influencing factors. The response rate was 87.9% (883/1005). No significant differences were found among medical schools with regard to first-choice specialty. Surgery (22.5%), medicine (19.0%), general practice (17.6%) and paediatrics (16.1%) were the top career choices. Work-life balance, perceived aptitude and skills, intellectual satisfaction, and amount of patient contact were rated as the most important job-related factors by most respondents. Few differences were found among schools in terms of the impact of job-related factors on future career preferences. Students for whom the work-life balance was extremely important (odds ratio [OR]=0.6) were less likely to prefer surgery. Students for whom the work-life balance (OR=2.2) and continuity of care (OR=2.1) were extremely important were more likely to prefer general practice. Students' early career preferences were similar across the five medical schools. These preferences result from the interplay among demographic factors and the perceived characteristics of the various specialties. Maintaining a satisfactory work-life balance is very important to tomorrow's doctors, and the data hint that this may be breaking down some of the traditional gender differences in specialty choice. Longitudinal work is required to explore whether students' career preferences change as they progress through medical school and training. © Blackwell Publishing Ltd 2012.

The Integrated Medical Model: A Risk Assessment and Decision Support Tool for Space Flight Medical Systems

Science.gov (United States)

Kerstman, Eric; Minard, Charles; Saile, Lynn; deCarvalho, Mary Freire; Myers, Jerry; Walton, Marlei; Butler, Douglas; Iyengar, Sriram; Johnson-Throop, Kathy; Baumann, David

2009-01-01

The Integrated Medical Model (IMM) is a decision support tool that is useful to mission planners and medical system designers in assessing risks and designing medical systems for space flight missions. The IMM provides an evidence based approach for optimizing medical resources and minimizing risks within space flight operational constraints. The mathematical relationships among mission and crew profiles, medical condition incidence data, in-flight medical resources, potential crew functional impairments, and clinical end-states are established to determine probable mission outcomes. Stochastic computational methods are used to forecast probability distributions of crew health and medical resource utilization, as well as estimates of medical evacuation and loss of crew life. The IMM has been used in support of the International Space Station (ISS) medical kit redesign, the medical component of the ISS Probabilistic Risk Assessment, and the development of the Constellation Medical Conditions List. The IMM also will be used to refine medical requirements for the Constellation program. The IMM outputs for ISS and Constellation design reference missions will be presented to demonstrate the potential of the IMM in assessing risks, planning missions, and designing medical systems. The implementation of the IMM verification and validation plan will be reviewed. Additional planned capabilities of the IMM, including optimization techniques and the inclusion of a mission timeline, will be discussed. Given the space flight constraints of mass, volume, and crew medical training, the IMM is a valuable risk assessment and decision support tool for medical system design and mission planning.

Motivation in medical students

OpenAIRE

Kusurkar, R.A.

2012-01-01

Introduction The importance of motivation in learning behaviour and education is well-researched and proven in general education, but much less in medical education. There is sometimes focus on increasing the quantity of motivation, but the how and why need more evidence. The aims of this thesis were to gather insights and investigate medical students’ motivation, particularly the importance of quality of motivation, factors influencing and outcomes and to explore how these can be applied to ...

A survey exploring the knowledge and perceptions of senior medical students in Nepal toward generic medicines

Directory of Open Access Journals (Sweden)

Sudesh Gyawali

2016-08-01

Full Text Available Background: The accurate knowledge of generic medicine issues among future prescribers will enhance the prescribing of cost-effective medicines. This study aimed to explore the knowledge and perception of senior medical students about the generic medicines. Methodology: A cross-sectional study was conducted among 237 senior medical students (final year students and interns using a validated self-administered questionnaire. The collected data were analyzed using Statistical Package for the Social Sciences version 20 for windows and comparison of difference was done using linear by linear association. A p value of less than 0.05 was taken as statistically significant. Results: The average age (standard deviation of the respondents was 23.54 (1.39 years. Almost 5% of respondents correctly answered the question regarding the regulatory limits for bioequivalence. Almost two-thirds of respondents correctly agreed that generic medicine is bioequivalent to a brand-name medicine, and 79.3% and 72.5% of respondents correctly agreed that the medicine should be present in the same dosage form and same dose, respectively, as the brand-name medicines. However, almost half of the respondents had impression that brand-name medicines are required to meet higher safety standard than generic medicines. Almost 90% of respondents felt that advertisement by the drug companies would influence the use of brand-name medicine and they need more information about generic medicine. Conclusion: This study highlights the negative perception and knowledge deficit among the respondents. The students’ responses to almost all the statements were almost similar to the respondents’ academic year (final year students and interns, gender and nationality.

A business analytics capability framework

Directory of Open Access Journals (Sweden)

Ranko Cosic

2015-09-01

Full Text Available Business analytics (BA capabilities can potentially provide value and lead to better organisational performance. This paper develops a holistic, theoretically-grounded and practically relevant business analytics capability framework (BACF that specifies, defines and ranks the capabilities that constitute an organisational BA initiative. The BACF was developed in two phases. First, an a priori conceptual framework was developed based on the Resource-Based View theory of the firm and a thematic content analysis of the BA literature. Second, the conceptual framework was further developed and refined using a three round Delphi study involving 16 BA experts. Changes from the Delphi study resulted in a refined and confirmed framework including detailed capability definitions, together with a ranking of the capabilities based on importance. The BACF will help academic researchers and industry practitioners to better understand the capabilities that constitute an organisational BA initiative and their relative importance. In future work, the capabilities in the BACF will be operationalised to measure their as-is status, thus enabling organisations to identify key areas of strength and weakness and prioritise future capability improvement efforts.

Depression in medical students: current insights

Directory of Open Access Journals (Sweden)

Moir F

2018-05-01

Full Text Available Fiona Moir,1 Jill Yielder,2 Jasmine Sanson,3 Yan Chen4 1Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand; 2Medical Programme Directorate, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand; 3Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand; 4Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand Abstract: Medical students are exposed to multiple factors during their academic and clinical study that have been shown to contribute to high levels of depression, anxiety, and stress. The purpose of this article was to explore the issue of depression in the medical student population, including prevalence, causes, and key issues, along with suggestions for early identification and support from one medical school in New Zealand. After establishing that the prevalence of depression is higher for medical students than the general population, the key issues explored include assessment used in the program, characteristics of the student population (such as Type A personality and perfectionism, resilience, selection procedures, students’ motivation, and the nature of the clinical environment. This review includes several recommendations to improve students’ psychological health such as positioning well-being within an overarching comprehensive workplace wellness model and integrating peer and faculty-led support into the day-to-day running of the institution. It also highlights the advantages of the addition of a well-being curriculum, as skills to prevent and manage distress and depression are relevant in supporting the competencies required by medical practitioners. It concludes that medical schools need wide-ranging strategies to address the complexities associated with the particular student

Sensor Alerting Capability

Science.gov (United States)

Henriksson, Jakob; Bermudez, Luis; Satapathy, Goutam

2013-04-01

There is a large amount of sensor data generated today by various sensors, from in-situ buoys to mobile underwater gliders. Providing sensor data to the users through standardized services, language and data model is the promise of OGC's Sensor Web Enablement (SWE) initiative. As the amount of data grows it is becoming difficult for data providers, planners and managers to ensure reliability of data and services and to monitor critical data changes. Intelligent Automation Inc. (IAI) is developing a net-centric alerting capability to address these issues. The capability is built on Sensor Observation Services (SOSs), which is used to collect and monitor sensor data. The alerts can be configured at the service level and at the sensor data level. For example it can alert for irregular data delivery events or a geo-temporal statistic of sensor data crossing a preset threshold. The capability provides multiple delivery mechanisms and protocols, including traditional techniques such as email and RSS. With this capability decision makers can monitor their assets and data streams, correct failures or be alerted about a coming phenomena.

The future of practical skills in undergraduate medical education - an explorative Delphi-Study.